Slide tracheoplasty for the treatment of tracheoesophogeal fistulas

• Published in: Journal of pediatric surgery Vol. 49; no. 6; pp. 910 - 914
• Main Authors: Provenzano, Matthew J, Rutter, Michael J, von Allmen, Daniel, Manning, Peter B, Paul Boesch, R, Putnam, Philip E, Black, Angela P, de Alarcon, Alessandro
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2014
• Subjects: Adolescent; Anastomosis, Surgical - methods; Cardiopulmonary bypass; Child; Child, Preschool; Esophageal atresia; Esophagus - surgery; Female; Follow-Up Studies; Humans; Infant; Infant, Newborn; Larynx; Male; Pediatrics; Periosteum; Pneumonia; Reconstructive Surgical Procedures - methods; Recurrent; Retrospective Studies; Surgery; Trachea - surgery; Tracheoesophageal Fistula - surgery; Tracheomalacia; Tracheostomy; Treatment Outcome; Cardiopulmonary bypass; Pneumonia; Tracheomalacia; Periosteum; Esophageal atresia; Larynx; Recurrent
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2014.01.022

Abstract Purpose The purpose of this study is to determine the surgical outcome of slide tracheoplasty for the treatment of tracheoesophageal (TE) fistula in pediatric patients. Methods After internal review board approval, the charts of pediatric patients (0–18 years old) who had undergone slide tracheoplasty for tracheoesophageal fistula were retrospectively reviewed. Patient information and surgical outcomes were reviewed. Results Nine patients underwent slide tracheoplasty for correction of TE fistula. In five patients the original TE fistula was congenital. Other causes included battery ingestion, tracheostomy tube complications, foreign body erosion, and an iatrogenic injury. The average age at repair was 48 ± 64 months (range: 1–190). Seven patients had undergone previous TEF repair either open or endoscopically. There were no recurrences after repair. Two patients had sternal periosteum interposed between the esophagus and trachea. There were no TEF recurrences. A single patient had dehiscence of the tracheal anastomosis and underwent a second procedure. Conclusion Slide tracheoplasty is an effective method to treat complex TE fistulas. The procedure was not associated with any recurrences. This is the first description of a novel, effective, and safe method to treat TE fistulas.