Bronchoscopy and Fogarty Balloon Insertion of Distal Tracheo-Oesophageal Fistula for Oesophageal Atresia Repair With Video Illustration.
OBJECTIVE
During repair of esophageal atresia with distal tracheo-esophageal fistula, air leakage through the fistula during mechanical ventilation can cause respiratory demise.


METHODS
From February 2012 until November 2014, all patients with esophageal atresia and distal tracheo-esophageal fistula were subjected to preoperative tracheobronchoscopy. Relatively distal fistulas were cannulated with a Fogarty catheter and blocked by insufflation (video illustration). Relatively proximal distal fistulas were sealed by precise placement of a cuffed ventilation tube.


RESULTS
Nine of 12 patients received Fogarty balloon placement. The fistula of the remaining 3 patients were sealed by careful tube placement. No complications related to tracheobronchoscopy or Fogarty placement were noted. All procedures were uneventful.


CONCLUSIONS
Preoperative tracheobronchoscopy to evaluate the usefulness of Fogarty balloon insertion or correct tube placement for distal tracheo-esophageal fistula is a safe and easy to perform procedure that can avoid complications in type C esophageal atresia repair.
VU Medisch Centrum, Amsterdam, Noord-Holland, Netherlands.
Rico
R
Rinkel
Pediatric Surgical Center Amsterdam, Amsterdam, Netherlands.
Daan
D
Van Poll
VU Medisch Centrum, Amsterdam, Noord-Holland, Netherlands.
Renate
R
Sibarani-Ponsen
Pediatric Surgical Center Amsterdam, Amsterdam, Netherlands.
Christien
C
Sleeboom
Pediatric Surgical Center Amsterdam, Amsterdam, Netherlands r.bakx@amc.uva.nl.
Roel
R
Bakx
D001999:Bronchoscopy; D002404:Catheterization; D004933:Esophageal Atresia / Q000628:therapy*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007327:Insufflation; D011300:Preoperative Care; D014138:Tracheoesophageal Fistula / Q000628:therapy*
bronchoscopy; esophageal atresia; surgery; tracheo-esophageal fistula; tracheobronchoscopy