title: Surgical treatment of recurrent tracheo-esophageal fistula using a latissimus dorsi pedicled muscle flap--report of a case.
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.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, University of Occupational and Environmental Health School of Medicine, Fukuoka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Fujita
authors.forename: H
authors.initials: H
authors.lastname: Kawahara
authors.forename: H
authors.initials: H
authors.lastname: Yoshimatsu
authors.forename: K
authors.initials: K
authors.lastname: Nakamura
mesh_terms: D004933:Esophageal Atresia / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D012008:Recurrence; D012086:Reoperation; D013524:Surgical Flaps; D014138:Tracheoesophageal Fistula / Q000601:surgery*