Endoscopic management of recurrent tracheoesophageal fistula with trichloroacetic acid chemocauterization: a preliminary report.
OBJECTIVE
Open repair with a second thoracotomy is technically challenging and has a high risk of complications for the treatment of a recurrent tracheoesophageal fistula (RTEF). Therefore, less invasive endoscopic techniques have been developed. Here, we report on the chemocauterization with trichloroacetic acid (TCA) technique for endoscopic management of RTEF.


METHODS
Three patients who had an open repair with thoracotomy for congenital tracheoesophageal fistula and were diagnosed with RTEF were included in this study. Rigid ventilating bronchoscopy with telescopic magnification was used to evaluate and manage the RTEF. After identification of the fistula opening, a 50% TCA-soaked small cotton ball was applied in the opening 3 times during each session.


RESULTS
The mean number of procedures was 3.3, and the fistulae were closed in all cases. Closure of the fistula was confirmed by esophagogram and/or bronchoscopy. There were no postoperative complications.


CONCLUSIONS
The results of this study showed that chemocauterization with TCA can be safe and effective for the management of RTEF.
Sung
Myung-Whun
MW
Department of Otorhinolaryngology, College of Medicine and Research Center for Sensory Organs, Medical Research Center, Seoul National University, Seoul, South Korea. mwsung@snu.ac.kr
Chang
Hyun
H
Hah
J Hun
JH
Kim
Kwang Hyun
KH
D000293:Adolescent; D001999:Bronchoscopy / Q000379:methods*; D002404:Catheterization; D002424:Caustics / Q000008:administration & dosage / Q000627:therapeutic use*; D002425:Cautery / Q000379:methods*; D004940:Esophageal Stenosis / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012008:Recurrence; D012086:Reoperation; D013908:Thoracotomy; D014138:Tracheoesophageal Fistula / Q000151:congenital / Q000601:surgery*; D014238:Trichloroacetic Acid / Q000008:administration & dosage / Q000627:therapeutic use*
D002424:Caustics; D014238:Trichloroacetic Acid