Recurrent tracheoesophageal fistula in children is a challenging issue, associated to high morbidity and mortality, due to major scarring and inflammatory changes resulting from previous interventions and the disease itself. Most cases require surgical treatment, but the complexity of the situation may, sometimes, prevent the traditional approach by thoracotomy. We present the clinical case of a 2 year old child with esophageal atresia with proximal and distal fistula, and multiple fistula recurrences. After the fourth recurrence it was decided to use a transternal transpericardic approach to the trachea, with resection of two tracheal rings, ligation of esophageal portion of the fistula, interposition of autologous pericardium and tracheal anastomosis. Although this technique has been used in congenital or acquired tracheal stenosis in children, this is the first report in the literature on its use in recurrent tracheoesophageal fistula.
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Article Synopsis
- Recurrent tracheoesophageal fistula (rTEF) is a rare but complex condition that can develop after initial esophageal atresia repair, with surgical challenges stemming from tissue adhesions and previous surgeries.
- The study introduced two new localization methods for identifying rTEF during surgery and evaluated their effectiveness compared to traditional approaches.
- Results showed that using localization techniques significantly reduced both operation time and postoperative recovery duration, leading to improved surgical outcomes for patients with rTEF.
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