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Usefulness of large pleural flap for the treatment of children with recurrent tracheoesophageal fistula

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Abstract

Purpose

Recurrent tracheoesophageal fistula (RTF) complicates 5–11% of cases of children treated at birth for esophageal atresia with inferior tracheoesophageal fistula (ITF), and it represents an important problem of respiratory morbility and mortality. Surgical correction of RTF is complex with high incidence of recurrence. The aim of this work is to demonstrate the usefulness of large vascularized pleural flap in the treatment of RTF and the prevention of recurrences.

Methods

From 2000 to 2007, four children (3 males and 1 female) referred to our hospital for respiratory symptoms secondary to RTF. Diagnosis of RTF was made by bronchoscopy and esophagogram with contrast medium. Operative repair involved resection of the fistula, suture of trachea and esophagus followed by interposition of large vascularized pleural flap (PF).

Results

There were no complications during surgical procedure and after 48 h, with easy respiratory weaning after 24 h. Hospital discharge ranged from 5 to 10 days. Long-term follow-up (range 18 months–5 years) demonstrated no evidence of recurrences.

Conclusion

Large vascularized PF to closure RTF is a highly effective and physiologic method for preventing second recurrences.

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Authors and Affiliations

  1. UOC di Chirurgia Pediatrica, Azienda Ospedaliera “S. Camillo-Forlanini”, via Cicerone 60, 00193, Rome, Italy

    Vito Briganti & Alessandro Calisti

  2. Dipartimento di Anestesia Generale, Azienda Ospedaliera “S. Camillo-Forlanini”, Rome, Italy

    Giovanni Mangia

  3. Dipartimento di Radiologia Generale, Azienda Ospedaliera “S. Camillo-Forlanini”, Rome, Italy

    Pasquale Ialongo

Authors
  1. Vito Briganti
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  2. Giovanni Mangia
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  3. Pasquale Ialongo
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  4. Alessandro Calisti
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Corresponding author

Correspondence to Vito Briganti.

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Briganti, V., Mangia, G., Ialongo, P. et al. Usefulness of large pleural flap for the treatment of children with recurrent tracheoesophageal fistula. Pediatr Surg Int 25, 587–589 (2009). https://doi.org/10.1007/s00383-009-2399-6

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  • DOI: https://doi.org/10.1007/s00383-009-2399-6

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