-
The Journal of Thoracic and... Dec 2017
Topics: Dentures; Humans; Tracheoesophageal Fistula
PubMed: 28916214
DOI: 10.1016/j.jtcvs.2017.08.031 -
Cirugia Pediatrica : Organo Oficial de... Jul 2022Surgical repair of recurrent tracheoesophageal fistula has a high risk of complications. Therefore, various endoscopic techniques have been used to avoid complications. (Observational Study)
Observational Study
INTRODUCTION
Surgical repair of recurrent tracheoesophageal fistula has a high risk of complications. Therefore, various endoscopic techniques have been used to avoid complications.
OBJECTIVE
To understand the usefulness of trichloroacetic acid endoscopic application for the treatment of recurrent tracheoesophageal fistula.
MATERIALS AND METHODS
An observational, descriptive, retrospective, case-series-based study was carried out in a tertiary pediatric hospital. Records of patients with recurrent tracheoesophageal fistula from 2015 to 2021 were reviewed. All patients within this period underwent brushing and trichloroacetic acid application.
RESULTS
Mean time of recurrent tracheoesophageal fistula occurrence was 4.8 months (range: 1-19.2). Two patients had a small fistula (less than 4 mm), three patients had a medium fistula (4 mm), and two patients had a large fistula (more than 4 mm). Mean sessions for fistula closure were 2.2 (range: 1-4). Mean time between procedures was 22 days (range: 14-30). Mean follow-up since fistula closure confirmation was 33 months (range: 9-72), during which no recurrences were noted.
CONCLUSION
Endoscopic management of recurrent transesophageal fistula with trichloroacetic acid is a safe and effective procedure. Brushing and trichloroacetic acid combined improve success rates. Fistulas over 4 mm in diameter require more procedures. However, a larger patient cohort and a longer follow-up period are needed to confirm this.
Topics: Child; Endoscopy; Humans; Retrospective Studies; Rhinoplasty; Tracheoesophageal Fistula; Trichloroacetic Acid
PubMed: 35796082
DOI: 10.54847/cp.2022.03.13 -
Balkan Medical Journal Dec 2019Recurrence of tracheoesophageal fistula is a frequent complication after esophageal atresia repair. Acquired tracheoesophageal fistulas are long new fistulas that are...
BACKGROUND
Recurrence of tracheoesophageal fistula is a frequent complication after esophageal atresia repair. Acquired tracheoesophageal fistulas are long new fistulas that are localized at sites that are not typical of the congenital tracheoesophageal fistula. We present four cases to discuss the diagnostic and management challenges concerning various acquired tracheoesophageal fistula localizations.
CASE REPORT
We retrospectively evaluated the medical records of patients admitted with acquired tracheoesophageal fistula in the last 5 years. Among the 16 postoperative tracheoesophageal fistulas, 4 were classified as acquired tracheoesophageal fistula. Patients’ admission age ranged from 1 to 8 years. The female to male ratio was 2:2. The presented cases were admitted with recurrent respiratory tract infections, choking, and coughing. The acquired tracheoesophageal fistulas were observed between the esophagus and cervical trachea, between the esophagus and the right bronchus passing through intrathoracic abscess cavity, in the right bronchus, and between the colon conduit and trachea. One of the acquired tracheoesophageal fistulas healed spontaneously, whereas others required surgical ligation.
CONCLUSION
Acquired tracheoesophageal fistula most often occurs secondary to local or diffuse mediastinitis. Acquired tracheoesophageal fistula may appear at unusual sites not typical of congenital tracheoesophageal fistula, such as esophagus-to-right bronchus and conduit to trachea. Therefore, the unusual locations of acquired tracheoesophageal fistula should be borne in mind, and patients evaluated and managed more comprehensively.
Topics: Child; Child, Preschool; Esophageal Atresia; Female; Humans; Infant; Male; Postoperative Complications; Retrospective Studies; Tracheoesophageal Fistula
PubMed: 31742365
DOI: 10.4274/balkanmedj.galenos.2019.2019.8.60 -
Italian Journal of Pediatrics Sep 2017Children with congenital esophageal atresia (EA) and tracheoesophageal fistula (TEF) have chronic respiratory symptoms including recurrent pneumonia, wheezing and...
BACKGROUND
Children with congenital esophageal atresia (EA) and tracheoesophageal fistula (TEF) have chronic respiratory symptoms including recurrent pneumonia, wheezing and persistent cough. The aim of this study is to describe the clinical findings of a large group of children with EA and TEF surgically corrected and the instrumental investigation to which they have undergone in order to better understand the patient's needs and harmonize the care.
METHODS
A retrospective data collection was performed on 105 children with EA and TEF followed at Department of Pediatric Medicine of Bambino Gesù Children's Hospital (Rome, Italy) between 2010 and 2015.
RESULTS
69/105 (66%) children reported lower respiratory symptoms with a mean age onset of 2.2 ± 2.5 years and only 63/69 (91%) performed specialist assessment at Respiratory Unit. Recurrent pneumonia (33%) and wheezing (31%) were the most reported symptoms. The first respiratory evaluation was performed after surgically correction of gastroesophageal reflux (GER) at mean age of 3.9 ± 4.2 years. Twenty nine patients have undergone to chest CT with contrast enhancement detecting localized atelectasis (41%), residual tracheal diverticulum (34%), bronchiectasis (31%), tracheal vascular compression (21%), tracheomalacia (17%) and esophageal diverticulum (14%). Fifty three patients have undergone to airways endoscopy detecting tracheomalacia (66%), residual tracheal diverticulum (26%), recurrent tracheoesophageal fistula (19%) and vocal cord paralysis (11%).
CONCLUSIONS
Our study confirms that respiratory symptoms often complicate EA and TEF; their persistence despite medical and surgical treatment of GER means that other etiological hypothesis must be examined and that a complete respiratory diagnostic work up must be considered.
Topics: Age Distribution; Bronchoscopy; Child; Child, Preschool; Cohort Studies; Databases, Factual; Esophageal Atresia; Female; Hospitals, Pediatric; Humans; Incidence; Infant; Italy; Male; Prognosis; Respiratory Tract Diseases; Retrospective Studies; Risk Assessment; Severity of Illness Index; Sex Distribution; Tracheoesophageal Fistula
PubMed: 28870218
DOI: 10.1186/s13052-017-0396-2 -
The New England Journal of Medicine Aug 2018
Topics: Abnormalities, Multiple; Esophageal Atresia; Humans; Infant, Newborn; Radiography, Thoracic; Tracheoesophageal Fistula
PubMed: 30110585
DOI: 10.1056/NEJMicm1801712 -
Journal of Cardiothoracic Surgery Apr 2024To review and analyze the airway and anesthesia management methods for patients who underwent endoscopic closure of tracheoesophageal fistula (TEF) and to summarize the...
OBJECTIVE
To review and analyze the airway and anesthesia management methods for patients who underwent endoscopic closure of tracheoesophageal fistula (TEF) and to summarize the experience of intraoperative airway management.
METHOD
We searched the anesthesia information system of the First Affiliated Hospital of Nanjing Medical University for anesthesia cases of TEF from July 2020 to July 2023 and obtained a total of 34 anesthesia records for endoscopic TEF occlusion. The intraoperative airway management methods and vital signs were recorded, and the patients' disease course and follow-up records were analyzed and summarized.
RESULTS
The airway management strategies used for TEF occlusion patients included nasal catheter oxygen (NCO, n = 5), high-flow nasal cannula oxygen therapy (HFNC, n = 4) and tracheal intubation (TI, n = 25). The patients who underwent tracheal intubation with an inner diameter of 5.5 mm had stable hemodynamics and oxygenation status during surgery, while intravenous anesthesia without intubation could not effectively inhibit the stress response caused by occluder implantation, which could easily cause hemodynamic fluctuations, hypoxemia, and carbon dioxide accumulation. Compared with those in the TI group, the NCO group and the HFNC group had significantly longer surgical times, and the satisfaction score of the endoscopists was significantly lower. In addition, two patients in the NCO group experienced postoperative hypoxemia.
CONCLUSION
During the anesthesia process for TEF occlusions, a tracheal catheter with an inner diameter of 5.5 mm can provide a safe and effective airway management method.
Topics: Humans; Tracheoesophageal Fistula; Retrospective Studies; Intubation, Intratracheal; Oxygen; Hypoxia; Anesthesia
PubMed: 38570837
DOI: 10.1186/s13019-024-02737-4 -
The Journal of Clinical Pediatric... 2018Esophageal Atresia (EA) is defined as the congenital interruption of the continuity of the esophagus. Pediatric patients also have other congenital conditions, such as... (Review)
Review
BACKGROUND
Esophageal Atresia (EA) is defined as the congenital interruption of the continuity of the esophagus. Pediatric patients also have other congenital conditions, such as Tracheo-Esophageal Fistula (TEF).
CASE REPORT
A 7-year-old male with TEF referred by a Pediatric Cardiologist, with the principal complaint of "severe and generalized tooth wearing". Considering that the patient was systemically stable, it was decided to perform the oral procedures under local anesthesia and rubber-dam isolation with an antimicrobial prophylaxis regimen. The treatment consisted of the extraction of all maxillary primary incisors and canines and both first molars; in the mandibular arch, only the lower second right molar was extracted, and a distal shoe was placed. Pulpotomies were performed and preformed metallic crowns were placed on the remaining second primary molars, on both lower first molars, and on lower canines and lateral incisors. Finally, a fixed prosthesis was positioned in the upper arch, and cemented through orthodontic bands adapted to both crowned second molars. The patient has been maintained under close medical and dental control. The child showed satisfactory oral conditions, and the vomiting episodes had decreased significantly.
CONCLUSIONS
Dentists can learn and then participate in the integral health management of infants and young children affected with EA/TEF, particularly those with dental erosion.
Topics: Child; Dental Care; Esophageal Atresia; Gastroesophageal Reflux; Humans; Male; Tracheoesophageal Fistula
PubMed: 29750630
DOI: 10.17796/1053-4628-42.4.3 -
American Journal of Medical Genetics.... Dec 2021The acronym VATER/VACTERL refers to the rare nonrandom association of the following component features (CFs): vertebral defects (V), anorectal malformations (ARM) (A),...
The acronym VATER/VACTERL refers to the rare nonrandom association of the following component features (CFs): vertebral defects (V), anorectal malformations (ARM) (A), cardiac anomalies (C), tracheoesophageal fistula with or without esophageal atresia (TE), renal malformations (R), and limb anomalies (L). For the clinical diagnosis, the presence of at least three CFs is required, individuals presenting with only two CFs have been categorized as VATER/VACTERL-like. The majority of VATER/VACTERL individuals displays a renal phenotype. Hitherto, variants in FGF8, FOXF1, HOXD13, LPP, TRAP1, PTEN, and ZIC3 have been associated with the VATER/VACTERL association; however, large-scale re-sequencing could only confirm TRAP1 and ZIC3 as VATER/VACTERL disease genes, both associated with a renal phenotype. In this study, we performed exome sequencing in 21 individuals and their families with a renal VATER/VACTERL or VATER/VACTERL-like phenotype to identify potentially novel genetic causes. Exome analysis identified biallelic and X-chromosomal hemizygous potentially pathogenic variants in six individuals (29%) in B9D1, FREM1, ZNF157, SP8, ACOT9, and TTLL11, respectively. The online tool GeneMatcher revealed another individual with a variant in ZNF157. Our study suggests six biallelic and X-chromosomal hemizygous VATER/VACTERL disease genes implicating all six genes in the expression of human renal malformations.
Topics: Anorectal Malformations; Cytoskeletal Proteins; DNA-Binding Proteins; Esophageal Atresia; Female; Genes, X-Linked; Genetic Association Studies; Genetic Predisposition to Disease; HSP90 Heat-Shock Proteins; Heart Diseases; Hemizygote; Homeodomain Proteins; Humans; Kidney; Male; Receptors, Interleukin; Tracheoesophageal Fistula; Transcription Factors; Exome Sequencing
PubMed: 34338422
DOI: 10.1002/ajmg.a.62447 -
Cirugia Y Cirujanos 2021Post-intubation tracheoesophageal fistula is a severe complication in long-term mechanical ventilation patients with possible fatal consequences. (Review)
Review
BACKGROUND
Post-intubation tracheoesophageal fistula is a severe complication in long-term mechanical ventilation patients with possible fatal consequences.
OBJECTIVE
To describe a case of post-intubation tracheoesophageal fistula and its surgical management. In addition, a brief literature review was effectuated.
CASE REPORT
45-year-old female, suffers ischemic stroke with progressive neurological damage that requires long-term mechanical ventilation. During endoscopic gastrostomy tracheoesophageal fistula is shown.
RESULTS
Undergoes surgery for esophageal repair and tracheal resection, through cervicosternotomy. Unfortunately died in the immediate postoperative period.
CONCLUSIONS
This complex pathology requires structured protocols for its prevention in patients in whom long-term mechanical ventilation is expected.
Topics: Esophagoplasty; Female; Humans; Iatrogenic Disease; Intubation, Intratracheal; Middle Aged; Respiration, Artificial; Tracheoesophageal Fistula
PubMed: 34851590
DOI: 10.24875/CIRU.20000730 -
Respiratory Care Apr 2005Tracheostomy may be associated with numerous acute, perioperative complications, some of which continue to be relevant well after the placement of the tracheostomy. A... (Review)
Review
Tracheostomy may be associated with numerous acute, perioperative complications, some of which continue to be relevant well after the placement of the tracheostomy. A number of clinically important unique late complications have been recognized as well, including the formation of granulation tissue, tracheal stenosis, tracheomalacia, tracheoinnominate-artery fistula, tracheoesophageal fistula, ventilator-associated pneumonia, and aspiration. The clinical relevance of these complications is considerable, as their manifestations range from minimally symptomatic to failure to wean from the ventilator (tracheal stenosis) to life-threatening hemorrhage (tracheoinnominate fistula). Treatment modalities vary depending upon the nature of the complication. For the most frequent complication, tracheal stenosis, a multidisciplinary approach utilizing bronchoscopy, laser, airway stents, and tracheal surgery is most effective.
Topics: Arterio-Arterial Fistula; Humans; Ischemia; Pneumonia; Pneumonia, Aspiration; Trachea; Tracheal Stenosis; Tracheoesophageal Fistula; Tracheostomy
PubMed: 15807919
DOI: No ID Found