title: Role of preoperative tracheobronchoscopy in newborns with esophageal atresia: A review.
abstract: Preoperative tracheobronchoscopy (TBS) in the diagnostic assessment of newborns affected by esophageal atresia (EA) was described in 1981. Nevertheless, the value of the procedure is actually much debated; only a few studies have clearly explored the advantages of TBS and this procedure is not yet routinely included in the diagnostic and therapeutic assessment in many international pediatric surgery settings. Routine preoperative TBS is a safe procedure that enables the accurate examination of the tracheobronchial tree, the visualization of tracheoesophageal fistula and the diagnosis of tracheomalacia or associated respiratory anomalies. When a distal fistula is found, its occlusion with a Fogarty balloon catheter improves mechanical ventilation and facilitates surgical repair. This review provides a detailed overview on the use of TBS in newborns with EA, focusing on technical aspects, anesthesiological management, indications and limits. The benefits and risks of the procedure are also compared with alternative diagnostic tools, such as an esophageal contrast study, computed tomography scan and ultrasound.
authors.affiliation: Filippo Parolini, Giovanni Boroni, Daniele Alberti, Department of Pediatric Surgery, Azienda Ospedaliera Spedali Civili, 25123 Brescia, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Parolini
authors.affiliation: Filippo Parolini, Giovanni Boroni, Daniele Alberti, Department of Pediatric Surgery, Azienda Ospedaliera Spedali Civili, 25123 Brescia, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Boroni
authors.affiliation: Filippo Parolini, Giovanni Boroni, Daniele Alberti, Department of Pediatric Surgery, Azienda Ospedaliera Spedali Civili, 25123 Brescia, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Stefini
authors.affiliation: Filippo Parolini, Giovanni Boroni, Daniele Alberti, Department of Pediatric Surgery, Azienda Ospedaliera Spedali Civili, 25123 Brescia, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Agapiti
authors.affiliation: Filippo Parolini, Giovanni Boroni, Daniele Alberti, Department of Pediatric Surgery, Azienda Ospedaliera Spedali Civili, 25123 Brescia, Italy.
authors.forename: Tullia
authors.initials: T
authors.lastname: Bazzana
authors.affiliation: Filippo Parolini, Giovanni Boroni, Daniele Alberti, Department of Pediatric Surgery, Azienda Ospedaliera Spedali Civili, 25123 Brescia, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Alberti
keywords: Computed tomography scan; Esophageal atresia; Newborns; Tracheobronchoscopy; Tracheoesophageal fistula; Tracheomalacia