Pediatric Surgery International

, Volume 34, Issue 7, pp 715–719 | Cite as

Experience of diagnosis and treatment of 31 H-type tracheoesophageal fistula in a single clinical center

  • Jiangtao Dai
  • Zhengxia Pan
  • Quan Wang
  • Yuhao Wu
  • Junke Wang
  • Gang Wang
  • Chun Wu
  • Yi Wang
Original Article



To summarize the experience of the diagnosis and treatment of 31 H-type tracheoesophageal fistula (TEF) at the Children’s Hospital of Chongqing Medical University, Chongqing, China.


A total of 31 patients with H-type TEF were enrolled in this retrospective study from January 2000 to July 2017, and the diagnosis and treatment of the disease were analyzed and summarized.


Iodine oil examination of the esophagus, fiberoptic bronchoscopy combined with esophagoscopy and three-dimensional computed tomography (3-D CT) reconstruction of the trachea and esophagus was used separately in 31 patients. 1 patient who had his TEF ligatured directly experienced recurrence 1 month after surgery, but recovered after TEF suturing. Subsequently, the remaining 30 patients were treated by suturing after TEF excision. All patients were followed up for 3 months–2 years and did not suffer from anastomosis orifice stenosis, gastroesophageal reflux, and a recurrent respiratory tract infection. Three patients exhibited vocal cord paralysis and improved spontaneously after a follow-up of 3–6 months.


H-type TEF is diagnosed by iodine oil examination of the esophagus, fiberoptic bronchoscopy combined with esophagoscopy, and 3-D CT reconstruction of the trachea and esophagus. Excision and suturing of the TEF separately are an effective treatment for the disease and are an excellent outcome.


H-type tracheoesophageal fistula Esophageal atresia Diagnosis Treatment Experience 



This project was supported by the National Key Clinical Specialist Construction Programs of China [National Health Office Letter (2013) 544].

Author contributions

Study conception and design: Yi Wang and Chun Wu. Data acquisition: Yuhao Wu and Quan Wang. Analysis and data interpretation: Gang Wang and Zhengxia Pan. Drafting of the manuscript: Jiangtao Dai. Critical revision: Junke Wang. Jiangtao Dai contributed the first authorship. Chun Wu and Yi Wang contributed correspondent author. Final approval of the version to be published: Yi Wang and Chun Wu.

Compliance with ethical standards

Conflict of interest

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

Research involving human participants and/or animals

For retrospective studies, ethical approval is not required. This article does not contain any studies with human participants performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Zani A, Jamal L, Cobellis G, Wolinska JM, Fung S, Propst EJ, Chiu PP, Pierro A (2017) Long-term outcomes following H-type tracheoesophageal fistula repair in infants. Pediatr Surg Int 33(2):187–190. CrossRefPubMedGoogle Scholar
  2. 2.
    Elebute OA, Ademuyiwa AO, Seyi-Olajide JO, Bode CO (2013) H-type tracheo-oesophageal fistula: a diagnostic challenge in a resource-poor country. A case report. Niger Postgrad Med J 20(3):234–236PubMedGoogle Scholar
  3. 3.
    Singh S, Wakhlu A (2012) Megaesophagus in the pediatric age group: a diagnostic dilemma. H-type tracheoesophageal fistula (H-type TEF). Saudi J Gastroenterol Off J Saudi Gastroenterol Assoc 18(2):151–152. CrossRefGoogle Scholar
  4. 4.
    Riazulhaq M, Elhassan E (2012) Early recognition of h-type tracheoesophageal fistula. APSP J Case Rep 3(1):4PubMedPubMedCentralGoogle Scholar
  5. 5.
    Allal H, Montes-Tapia F, Andina G, Bigorre M, Lopez M, Galifer RB (2004) Thoracoscopic repair of H-type tracheoesophageal fistula in the newborn: a technical case report. J Pediatr Surg 39(10):1568–1570CrossRefPubMedGoogle Scholar
  6. 6.
    Aziz GA, Schier F (2005) Thoracoscopic ligation of a tracheoesophageal H-type fistula in a newborn. J Pediatr Surg 40(6):e35–e36. CrossRefPubMedGoogle Scholar
  7. 7.
    Hajjar WM, Iftikhar A, Al Nassar SA, Rahal SM (2012) Congenital tracheoesophageal fistula: a rare and late presentation in adult patient. Ann Thorac Med 7(1):48–50. CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Amat F, Heraud MC, Scheye T, Canavese M, Labbe A (2012) Flexible bronchoscopic cannulation of an isolated H-type tracheoesophageal fistula in a newborn. J Pediatr Surg 47(10):e9–e10. CrossRefPubMedGoogle Scholar
  9. 9.
    Qian C, Xu Z, Wang Q, Tan L, Xu S, Jiang W (2006) Surgical treatment of H-type tracheoesophageal fistula: a report of 6 cases. Chin J Clin Med 13(2):231–232. CrossRefGoogle Scholar
  10. 10.
    Ren H, Chen L, Chen S, Wu X (2010) One case of H-type tracheoesophageal fistula was treated by thoracoscope. Chin J Pediatr Surg 31(10):802–803. CrossRefGoogle Scholar
  11. 11.
    Zhao Y, Zhao L, Ye H, Zhang J, Liu G, Huang L, Wang S (2007) Application of thoracoscopy in esophageal anastomosis in infants. Beijing Med J 29(3):188. CrossRefGoogle Scholar
  12. 12.
    Patkowsk D, Rysiakiewicz K, Jaworski W, Zielinska M, Siejka G, Konsur K, Czernik J (2009) Thoracoscopic repair of tracheoesophageal fistula and esophageal atresia. J Laparoendosc Adv Surg Tech Part A 19(Suppl 1):S19–S22. CrossRefGoogle Scholar
  13. 13.
    Parolini F, Morandi A, Macchini F, Gentilino V, Zanini A, Leva E (2014) Cervical/thoracotomic/thoracoscopic approaches for H-type congenital tracheo-esophageal fistula: a systematic review. Int J Pediatr Otorhinolaryngol 78(7):985–989. CrossRefPubMedGoogle Scholar
  14. 14.
    Al-Salem AH, Mohaidly MA, Al-Buainain HM, Al-Jadaan S, Raboei E (2016) Congenital H-type tracheoesophageal fistula: a national multicenter study. Pediatr Surg Int 32(5):487–491. CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Cardio-Thoracic SurgeryChildren’s Hospital of Chongqing Medical UniversityChongqingPeople’s Republic of China
  2. 2.Ministry of Education Key Laboratory of Child Development and DisordersChina International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of PediatricsChongqingPeople’s Republic of China
  3. 3.Pediatric Intensive Care UnitChildren’s Hospital of Chongqing Medical UniversityChongqingPeople’s Republic of China

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