Skip to main content
Log in

Surgical treatment of recurrent tracheo-esophageal fistula using a latissimus dorsi pedicled muscle flap —Report of a case—

  • Case Reports
  • Published:
The Japanese journal of surgery Aims and scope Submit manuscript

Abstract

We report herein, a case of a child in whom a prepared latissimus dorsi muscle flap was successfully utilized in the treatment of recurrent tracheo-esophageal fistula (TEF). A 12-month-old girl who had undergone a primary repair of Gross’s type C esophageal atresia at 6 days of age and a secondary repair of recurrent TEF at 4 months of age experienced, postoperatively, repeated episodes of aspiration pneumonia caused by recurrence of the fistula. Thus, we performed a reoperation in which the fistula was excised, and a latissimus dorsi muscle pedicled flap was interposed between the tracheal and esophageal suture lines. Viability of the muscle flap was adequately achieved by means of a three-stage delayed operation. Although a minor anastomotic leakage of the esophagus was found postoperatively, it healed spontaneously, and the patient was commenced on a normal diet orally without any problems at 26 months of age.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Kafrouni G, Baick CH, Woolley MM. Recurrent tracheoesophageal fistula: a diagnostic problem. Surgery 1970; 68: 889–894.

    PubMed  CAS  Google Scholar 

  2. Niinomi N, Ito T, Sugito T, Nagaya M, Yamada N, Ishiguro Y, Furukawa H, Okagawa D, Suzuki H, Tsuda M, Shimoji H, Iida M. Recurrent tracheo-esophageal fistula. Nippon Shyoni Geka Gakkai Zasshi (J Jpn Soc Pediatr Surg) 1979; 15: 499–506. (English Abst.)

    Google Scholar 

  3. Ein SH, Stringer DA, Stephens CA, Shandling B, Simpson J, Filler RM. Recurrent tracheoesophageal fistulas seventeen-year review. J Pediatr Surg 1983; 18: 436–441.

    PubMed  CAS  Google Scholar 

  4. Hashimoto S, Yura J, Tsuruga N, Ito A, Takahashi H, Mizuno T. Recurrent TEF after repair of congenital esophageal atresia; a case report of successful repair with ligation and review of literatures. Shyoni Geka Naika (Jpn J Pediatr Surg & Med) 1975; 7: 1047–1102. (in Japanese)

    Google Scholar 

  5. Slim MS, Tabry IF. Left extrapleural approach for the repair of recurrent tracheoesophageal fistula. J Thorac Cardiovasc Surg 1974; 68: 654–657.

    PubMed  CAS  Google Scholar 

  6. Moskovitz WS, Hughes CW, Bowers WF. Recurrent tracheoesophageal fistula. Am J Surg 1960; 100: 110–112.

    Article  PubMed  CAS  Google Scholar 

  7. Nakamura K, Kajimoto T, Ohama K, Kawanaka T, Kitatani H. Recurrence and recommunication of TEF in C-type esophageal atresia. Nippon Shyoni Geka Gakkai Zasshi. (J Jpn Soc Pediatr Surg) 1982; 18: 1353–1361. (English Abst.)

    Google Scholar 

  8. Falletta GP. Recommunication on repair of congenital tracheoesophageal fistula; report of a case and review of literature. Arch Surg 1964; 88: 779–786.

    PubMed  CAS  Google Scholar 

  9. Gustafson RA, Hrabovsky EE. Intercostal muscle and myo-osseous flaps in difficult pediatric thoracic problems. J Pediatr Surg 1982; 17: 541–545.

    PubMed  CAS  Google Scholar 

  10. Fujita H, Kawahara H, Hidaka M, Murakami M, Yoshimatsu H. Congenital esophago-bronchial fistula in the adult, associated with carcinoid tumorlets. Nippon Kyobu Geka Gakkai Zasshi (J Jpn Assoc Thorac Surg) 1986; 34: 230–235. (English Abst.)

    PubMed  CAS  Google Scholar 

  11. Black MJM, Chait L, O’Brien BM, Sykes PJ, Sharzer LA. How soon may the axial vessels of a surviving free flap be safely ligated: a study in pigs. Brit J Plast Surg 1978; 31: 295–299.

    PubMed  CAS  Google Scholar 

  12. Khoo CTK, Bailey BN. The behaviour of free muscle and musculocutaneous flaps after early loss of axial blood supply. Brit J Plast Surg 1982; 35: 43–46.

    Article  PubMed  CAS  Google Scholar 

  13. Hoffmeister FS. Studies on timing of tissue transfer in reconstructive surgery Paper # 1. Effect of delay on circulation in flaps. Plast Reconstr Surg 1957; 19: 283–298.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fujita, H., Kawahara, H., Yoshimatsu, H. et al. Surgical treatment of recurrent tracheo-esophageal fistula using a latissimus dorsi pedicled muscle flap —Report of a case—. The Japanese Journal of Surgery 19, 78–81 (1989). https://doi.org/10.1007/BF02471572

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02471572

Key Words

Navigation