Endoscopic treatment of congenital H-Type and recurrent tracheoesophageal fistula with electrocautery and histoacryl glue

Department of Pediatric Otorhinolaryngology Head and Neck Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, Ont., Canada M5G 1X8.
International Journal of Pediatric Otorhinolaryngology (Impact Factor: 1.19). 06/2006; 70(5):925-30. DOI: 10.1016/j.ijporl.2005.10.017
Source: PubMed


Congenital H-Type tracheoesophageal fistulae (H-Type TEF) and recurrent fistulae after primary repair of esophageal atresia represent a difficult problem in diagnosis and management. The treatment traditionally involved an open technique via a cervical or thoracic route, approaches with high morbidity and mortality rates of up to 50%. Endoscopic closure of fistulae has been reported with various techniques such as tissue adhesives, electrocautery, sclerosants and laser. However, the published case series contain a small number of patients with usually short-term follow-up. The aim of this paper is to present the experience of a decade at Toronto's Hospital for Sick Children, using diathermy and histoacryl tissue adhesive and discuss the indications and limitations of this technique.

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    • "Literature reports up to 50% overall morbidity and mortality in surgical reintervention for tracheoesophageal fistula after esophageal atresia repair in children [4]. In our case, with a patient in very good general condition, a well localized fistula with small fistular orifices and no sign of large adjacent necrosis, an endoscopic approach was our first management approach. "
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