Clinical Experience of H-type Tracheoesophageal Fistula.
- Author:
Hwui Dong CHO
1
;
So Hyun NAM
;
Min Jeng CHO
;
Tae Hoon KIM
;
Dae Yeon KIM
;
Seong Chul KIM
;
In Koo KIM
Author Information
1. Department of Pediatric Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. sckim@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
H-type fistula;
Esophageal atresia;
Tracheoesophageal fistula;
Cervical incision
- MeSH:
Cough;
Esophageal Atresia;
Esophagus;
Fistula;
Gestational Age;
Humans;
Medical Records;
Parturition;
Pneumonia, Aspiration;
Trachea;
Tracheoesophageal Fistula;
Vocal Cord Paralysis;
Vomiting
- From:Journal of the Korean Association of Pediatric Surgeons
2011;17(2):154-161
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Tracheoesophageal fistula without esophageal atresia (H-type TEF) is a congenital anomaly that is characterized by a fistula between the posterior wall of the trachea and the anterior wall of the esophagus, not accompanied by esophageal atresia. The purpose of this study is to investigate the clinical characteristics, diagnostic time, the side of cervical approach and short term result after surgery by searching medical records of patients treated for H-type TEF. The search was done at University of Ulsan, Department of Pediatric Surgery of Asan Medical Center, and the total number of patients from May 1989 to December 2010 was 9 with M:F ratio of 1:2. The median gestational age was 39(+6) (32(+6)~41(+0)) wks. Seven out of nine patients were born at term and the other two were born premature. The clinical presentation was aspiration pneumonia, difficulty in feeding, chronic cough, vomiting, abdominal distension and growth retardation. The symptoms presented right after birth. The diagnosis was made with esophagography and the median time of diagnosis was 52 days of life. The majority of surgical corrections were performed within two weeks of diagnosis (median; 15d, range; 1d - 6m). Six patients had associated anomalies, and cardiac anomalies were most common. The cervical approach was utilized in all cases (right 2, left 7). Transient vocal cord palsy and minor esophageal leakage complicated two cases. Although the diagnosis of H-type TEF was difficult and often delayed, we had a good short term result. The left cervical approach was preferred.
