Materiały źródłowe

• #1 Oesophageal atresia and tracheo‐oesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2672849/

  Oesophageal atresia (OA) and tracheooesophageal fistula (TOF) has been a key domain of paediatric surgery since its early beginnings and continues to challenge specialists who care for these vulnerable children. […] With overall survival now exceeding 90% in dedicated centres, emphasis in the modern era has been on reducing morbidity and achieving improvements in the quality of life. […] An overview of current and emerging strategies in managing patients with OATOF is presented. […] Operative repair of OATOF follows well established surgical techniques. […] A right posterolateral (extrapleural) thoracotomy is performed, the fistula ligated, and primary oesophageal anastomosis created. […] Almost 60 years after the first successful primary repair, another landmark in the management of OA was achieved by Tom Lobe and Steve Rothenberg from North America when they undertook the first minimally invasive thoracoscopic repair of OATOF.

• #2 Tracheoesophageal Fistula: Types, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/23395-tracheoesophageal-fistula

  Tracheoesophageal fistula treatment involves corrective surgery. During this procedure, the connection between your babys esophagus and trachea is repaired. This may be done using traditional or minimally invasive techniques. […] Yes. Tracheoesophageal fistula is curable with surgical intervention. Because its a life-threatening condition, it should be treated immediately.

• #3 Tracheoesophageal fistula and esophageal atresia repair: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/002934.htm

  Tracheoesophageal fistula and esophageal atresia repair is surgery to repair two birth defects in the esophagus and trachea. The defects usually occur together. […] This surgery is almost always done soon after birth. Both defects can often be repaired at the same time. Briefly, the surgery takes place this way: […] Often the two parts of the esophagus are too far apart to sew together right away. In this case: […] Sometimes the surgeon will wait 2 to 4 months before doing the surgery. Waiting allows your baby to grow or have other problems treated. […] Tracheoesophageal fistula and esophageal atresia are life-threatening problems. They need to be treated right away. […] After surgery, your child will be cared for in the hospital’s NICU. […] Surgery can usually repair a TEF and EA. Once healing from the surgery is complete, your child may have these problems: […] During infancy and early childhood, many children will have problems with breathing, growth, and feeding, and will need to continue seeing both their primary care provider and specialists.

• #4 Oesophageal atresia and tracheo-oesophageal fistula

  https://www.nhs.uk/conditions/oesophageal-atresia/

  An operation to repair an oesophageal atresia and tracheo-oesophageal fistula is usually done soon after birth. […] Your baby will be taken to the neonatal intensive care unit, where they’re given a general anaesthetic. […] They’ll receive nutrition into a vein (intravenously) and a suction tube will be used to remove fluid from the pouch in their oesophagus. […] The surgeon makes a cut on the right side of the chest, between the ribs, and closes off the abnormal connection (fistula) between the oesophagus and windpipe. They’ll then sew together the upper and lower parts of the oesophagus. […] If the gap in the oesophagus is large, your child may need to wait a few months for the operation, to allow their oesophagus to grow a bit more. […] Occasionally, a procedure to lengthen the oesophagus before repairing it may be carried out.

• #5 Oesophageal atresia and tracheo-oesophageal fistula in neonates | Safer Care Victoria

  https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/neonatal/oesophageal-atresia-and-tracheo-oesophageal-fistula-in-neonates

  Oesophageal atresia (OA) involves an interruption to the lumen of the oesophagus, with the oesophagus ending in a blind pouch. OA is usually associated with a tracheo-oesophageal fistula (TOF), which is an abnormal connection between the oesophagus and the trachea. […] Regular, thorough suctioning of the upper oesophageal pouch is required prior to definitive surgical repair. […] Referral to PIPER and a tertiary neonatal surgical unit should be made as soon as possible. […] Management of oesophageal atresia and TOF involves: If oesophageal atresia is suspected antenatally baby should be delivered close to a Level 6 surgical neonatal unit. […] The neonate must be kept nil by mouth, commenced on intravenous fluids and nursed supine in a head up position (approximately 30-60 degrees).

• #6 Oesophageal atresia and tracheo-oesophageal fistula

  https://www.nhs.uk/conditions/oesophageal-atresia/

  An operation to repair an oesophageal atresia and tracheo-oesophageal fistula is usually done soon after birth. […] Your baby will be taken to the neonatal intensive care unit, where they’re given a general anaesthetic. […] They’ll receive nutrition into a vein (intravenously) and a suction tube will be used to remove fluid from the pouch in their oesophagus. […] The surgeon makes a cut on the right side of the chest, between the ribs, and closes off the abnormal connection (fistula) between the oesophagus and windpipe. They’ll then sew together the upper and lower parts of the oesophagus. […] If the gap in the oesophagus is large, your child may need to wait a few months for the operation, to allow their oesophagus to grow a bit more. […] Occasionally, a procedure to lengthen the oesophagus before repairing it may be carried out.

• #7 Oesophageal atresia and tracheo-oesophageal fistula | NHSGGC

  https://clinicalguidelines.scot.nhs.uk/ggc-paediatric-guidelines/ggc-paediatric-guidelines/neonatology/oesophageal-atresia-and-tracheo-oesophageal-fistula/

  This guideline is applicable to all medical, nursing and midwifery staff caring for neonates in the West of Scotland. All neonates with a diagnosis of oesophageal atresia (OA) and/or tracheo-oesophageal Fistula (TOF) will be referred to the neonatal surgical unit at the Queen Elizabeth Hospital (QEH). […] Babies born with OA/TOF need to have intensive neonatal care prior to corrective surgery, normally within days of birth. […] If the X-ray confirms the diagnosis of oesophageal atresia, follow the guidelines for ongoing care. The infant also needs be examined for other associated abnormalities (including congenital cardiac disease and anorectal malformation). […] A Replogle tube is passed as soon as the diagnosis of trachea-oesophageal atresia is suspected / recognised. It is maintained within the pre-operative period to clear secretions continuously that would otherwise put the baby at risk of aspiration. Surgical intervention is normally undertaken when the infant is stable (usually within 48hours).

• #8 Oesophageal atresia and tracheo-oesophageal fistula in neonates | Safer Care Victoria

  https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/neonatal/oesophageal-atresia-and-tracheo-oesophageal-fistula-in-neonates

  The upper pouch must be kept clear of secretions by frequent oral suctioning to 1 cm above the distal end of the oesophageal pouch (every 15 minutes or more frequently as required). […] Another method of oesophageal pouch suction is to position a Replogle tube 0.5 cm above the end of the oesophageal pouch and connect the Repogle tube to continuous low pressure suction (10 cm H2O) to aspirate saliva and prevent aspiration. […] Antibiotics are recommended if there is evidence of aspiration pneumonia or for presumed sepsis. […] The patient should be transported to a Level 6 surgical neonatal unit as soon as possible. In most cases early primary surgical repair is appropriate. […] A multidisciplinary approach, including surgeon, respiratory physician, physiotherapist, dietitian and speech therapist is needed.

• #9 Oesophageal atresia and tracheo-oesophageal fistula

  https://www.nhs.uk/conditions/oesophageal-atresia/

  An operation to repair an oesophageal atresia and tracheo-oesophageal fistula is usually done soon after birth. […] Your baby will be taken to the neonatal intensive care unit, where they’re given a general anaesthetic. […] They’ll receive nutrition into a vein (intravenously) and a suction tube will be used to remove fluid from the pouch in their oesophagus. […] The surgeon makes a cut on the right side of the chest, between the ribs, and closes off the abnormal connection (fistula) between the oesophagus and windpipe. They’ll then sew together the upper and lower parts of the oesophagus. […] If the gap in the oesophagus is large, your child may need to wait a few months for the operation, to allow their oesophagus to grow a bit more. […] Occasionally, a procedure to lengthen the oesophagus before repairing it may be carried out.

• #10 Esophageal Atresia With or Without Tracheoesophageal Fistula Treatment & Management: Approach Considerations, Indications for and Timing of Surgical Intervention, Options for Surgery

  https://emedicine.medscape.com/article/935858-treatment

  The treatment plan for each baby must be individualized. The prognostic classifications can provide guidance in patients with multiple problems, but early and decisive identification of the most life-threatening anomaly is essential. […] Management plans for a delayed repair of the esophageal atresia may include placing a 10-French Replogle double-lumen tube through the mouth or nose well into the upper pouch to provide continuous suction of pooled secretions from the proximal portion of the atretic esophagus. […] Prophylactic broad-spectrum antibiotics (eg, ampicillin and gentamicin) may be used. General supportive care and total parenteral nutrition (TPN) are needed. […] A gastrostomy, distal tracheoesophageal fistula (TEF) ligation, or cervical esophagostomy may permit longer delays in the esophageal atresia repair.

• #11 Anaesthetic management of tracheo-oesophageal fistula/ oesophageal atresia : Virtual Library

  https://resources.wfsahq.org/atotw/anaesthetic-management-of-tracheo-oesophageal-fistula-oesophageal-atresia/

  Tracheo-oesophageal fistula (TOF) with or without oesophageal atresia (OA) has a worldwide incidence of 1 in 3000-4000 births, and most cases are diagnosed postnatally. […] Prior to surgical repair, a thorough preoperative assessment must be performed, paying close attention to the neonates respiratory and cardiac status including an echocardiogram to detect congenital heart disease lesions. […] Intraoperative considerations for TOF/OA repair include anticipation of difficulties with airway management, surgical technique, potential for blood loss, and plans for post-operative management. […] While outcomes in neonates with TOF/OA have improved significantly due to advances in surgical, anaesthetic, and critical care management, mortality rates remain high in low resource setting. […] A thorough preoperative assessment should focus on determining the presence and possible anesthetic implication of any coexisting congenital abnormalities, especially cardiac defects.

• #12 Anaesthetic management of tracheo-oesophageal fistula/ oesophageal atresia : Virtual Library

  https://resources.wfsahq.org/atotw/anaesthetic-management-of-tracheo-oesophageal-fistula-oesophageal-atresia/

  The high prevalence of congenital heart disease makes a preoperative echocardiogram a necessity. […] There are two main surgical approaches for TOF/OA repair: the traditional surgical approach via an open thoracotomy and the thoracoscopic approach. […] Anaesthetic management in the operating room should include routine monitors (EKG, blood pressure cuff, end tidal CO2, temperature probe, and one pulse oximeter unless a ductal-dependent cardiac lesion is present in which case two pulse oximeters are needed for the measurement of pre- and post-ductal saturations). […] The goal during induction is to intubate the infant while minimizing distention of the stomach. […] Once positioned, there are various ways to confirm placement of the endotracheal tube in good position just distal to the fistula.

• #13 Guidelines for treatment of esophageal atresia in the …

  https://ppch.pl/seo/article/01.3001.0015.8208/en

  Preoperative management: A standard procedure before surgery is chest and abdominal X-ray. […] Preoperative tracheobronchoscopy is mandatory and usually informs about the location of a proximal or a distal fistula and abnormalities of the respiratory tract, such as tracheobronchomalacia, change in vocal cords, cleft of airway. […] In 13.2% to 42% of cases EA can be associated with congenital heart disease and the most recent guidelines of ERNICA showed that echocardiography should be performed in every case. […] Surgical management of EA: Surgical management of EA should be performed in specialized centers which are hospitals with at least five new cases of EA per year. […] There are two main approaches to surgical repair of EA with primary anastomosis: Thoracotomy and Thoracoscopy. […] According to the recent publication from ERNICA, thoracoscopy is a viable option in the treatment of EA.

• #14 Guidelines for treatment of esophageal atresia in the …

  https://ppch.pl/seo/article/01.3001.0015.8208/en

  Preoperative management: A standard procedure before surgery is chest and abdominal X-ray. […] Preoperative tracheobronchoscopy is mandatory and usually informs about the location of a proximal or a distal fistula and abnormalities of the respiratory tract, such as tracheobronchomalacia, change in vocal cords, cleft of airway. […] In 13.2% to 42% of cases EA can be associated with congenital heart disease and the most recent guidelines of ERNICA showed that echocardiography should be performed in every case. […] Surgical management of EA: Surgical management of EA should be performed in specialized centers which are hospitals with at least five new cases of EA per year. […] There are two main approaches to surgical repair of EA with primary anastomosis: Thoracotomy and Thoracoscopy. […] According to the recent publication from ERNICA, thoracoscopy is a viable option in the treatment of EA.

• #15 Tracheoesophageal Fistula Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/186735-treatment

  Transfer infants and children with tracheoesophageal fistula (TEF) to a pediatric center experienced with surgical repair of TEF. The center should be experienced with providing support of critically ill pediatric patients. […] Surgical repair is required following confirmation of a diagnosis of tracheoesophageal fistula (TEF). Note the following: In healthy infants without pulmonary complications, primary repair is performed within the first few days of life. Repair is delayed in patients with low birth weight, pneumonia, or other major anomalies. Initially, treat patients conservatively with parenteral nutrition, gastrostomy, and upper pouch suction until they are considered to be low risk. […] Because acquired TEFs do not close spontaneously, surgical repair is planned if the patient is stable enough. Critically ill patients are managed conservatively until stable enough for a major surgical procedure.

• #16 Tracheoesophageal Fistula and Esophageal Atresia – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/tracheoesophageal-fistula-and-esophageal-atresia

  If your baby has TE fistula or esophageal atresia, he or she will need surgery to fix the problem. […] The type of surgery depends on the following: Type of abnormality, Overall health of the baby and medical history, Opinion of the surgeon and other healthcare providers involved in the baby’s care, Expectations for the course of the condition, Parents opinion and preference. […] When TE fistula is repaired, the connection between the esophagus and the trachea is closed in surgery. Repair of esophageal atresia depends on how close the two sections of esophagus are to each other. […] The repair of esophageal atresia or tracheoesophageal fistula with esophageal atresia can be accomplished with either open (thoracotomy) or minimally invasive surgical approaches. […] Sometimes multiple procedures are necessary to connect the upper and lower esophageal segments.

• #17 Tracheoesophageal Fistula and Esophageal Atresia | Children’s Hospital Los Angeles

  https://www.chla.org/esophageal-atresia-and-tracheoesophageal-fistulas

  Babies receive treatment for TEFs after they are born. Our specialists from the Fetal-Maternal Center will closely monitor you and your baby throughout pregnancy, working with you to carefully plan your delivery and outline an appropriate care plan and treatment options for your baby. […] For TEF with or without EA, your baby will have neonatal surgery within 48 hours after birth. Surgery for TEF helps prevent damage from food, fluids, saliva or mucus secretions that can get into the lungs. […] The type of surgery depends on your babys overall health and the type of TEF: […] Surgeons can usually repair the TEF in one surgery. They remove the connection between the trachea and esophagus. They also repair each structure so that your baby can swallow, eat, and breathe normally. […] In addition to closing the TEF, surgeons create a continuous esophagus from the throat to the stomach by connecting its two sections. If they are too far apart, your baby might need two surgeries, allowing time for the sections to grow.

• #18 Esophageal Atresia and Tracheoesophageal Fistula: Signs, Causes & Treatment

  https://www.whattoexpect.com/first-year/tracheoesophageal-atresia-and-tracheoesophageal-fistula.aspx

  When a baby is diagnosed with EA and/or TEF, doctors schedule surgery as soon as possible so that the baby can eat and his lungs dont get damaged often within 24 to 48 hours after birth. […] During surgery, which is done under general anesthesia, surgeons repair the esophagus so that it connects correctly from the throat to the stomach, and the fistula will also be closed up. The repair will help a baby feed normally, though in some cases, a baby might need to undergo multiple surgeries to fully correct the problem. […] If no other problems or birth defects are present, the chances are high that a baby with EA/TEF will recover fully. However, they might be at increased risk for gastroesophageal reflux disease (GERD) and related complications of the esophagus (like early esophagitis), respiratory complications like recurrent wheezing or poor growth. In those cases, medications and ongoing care from specialists may be needed.

• #19 Tracheoesophageal Fistula and Esophageal Atresia – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/tracheoesophageal-fistula-and-esophageal-atresia

  If your baby has TE fistula or esophageal atresia, he or she will need surgery to fix the problem. […] The type of surgery depends on the following: Type of abnormality, Overall health of the baby and medical history, Opinion of the surgeon and other healthcare providers involved in the baby’s care, Expectations for the course of the condition, Parents opinion and preference. […] When TE fistula is repaired, the connection between the esophagus and the trachea is closed in surgery. Repair of esophageal atresia depends on how close the two sections of esophagus are to each other. […] The repair of esophageal atresia or tracheoesophageal fistula with esophageal atresia can be accomplished with either open (thoracotomy) or minimally invasive surgical approaches. […] Sometimes multiple procedures are necessary to connect the upper and lower esophageal segments.

• #20 Anaesthetic management of tracheo-oesophageal fistula/ oesophageal atresia : Virtual Library

  https://resources.wfsahq.org/atotw/anaesthetic-management-of-tracheo-oesophageal-fistula-oesophageal-atresia/

  The high prevalence of congenital heart disease makes a preoperative echocardiogram a necessity. […] There are two main surgical approaches for TOF/OA repair: the traditional surgical approach via an open thoracotomy and the thoracoscopic approach. […] Anaesthetic management in the operating room should include routine monitors (EKG, blood pressure cuff, end tidal CO2, temperature probe, and one pulse oximeter unless a ductal-dependent cardiac lesion is present in which case two pulse oximeters are needed for the measurement of pre- and post-ductal saturations). […] The goal during induction is to intubate the infant while minimizing distention of the stomach. […] Once positioned, there are various ways to confirm placement of the endotracheal tube in good position just distal to the fistula.

• #21 Oesophageal atresia and tracheo‐oesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2672849/

  Oesophageal atresia (OA) and tracheooesophageal fistula (TOF) has been a key domain of paediatric surgery since its early beginnings and continues to challenge specialists who care for these vulnerable children. […] With overall survival now exceeding 90% in dedicated centres, emphasis in the modern era has been on reducing morbidity and achieving improvements in the quality of life. […] An overview of current and emerging strategies in managing patients with OATOF is presented. […] Operative repair of OATOF follows well established surgical techniques. […] A right posterolateral (extrapleural) thoracotomy is performed, the fistula ligated, and primary oesophageal anastomosis created. […] Almost 60 years after the first successful primary repair, another landmark in the management of OA was achieved by Tom Lobe and Steve Rothenberg from North America when they undertook the first minimally invasive thoracoscopic repair of OATOF.

• #22 Oesophageal atresia and tracheo-oesophageal fistula

  https://www.nhs.uk/conditions/oesophageal-atresia/

  An operation to repair an oesophageal atresia and tracheo-oesophageal fistula is usually done soon after birth. […] Your baby will be taken to the neonatal intensive care unit, where they’re given a general anaesthetic. […] They’ll receive nutrition into a vein (intravenously) and a suction tube will be used to remove fluid from the pouch in their oesophagus. […] The surgeon makes a cut on the right side of the chest, between the ribs, and closes off the abnormal connection (fistula) between the oesophagus and windpipe. They’ll then sew together the upper and lower parts of the oesophagus. […] If the gap in the oesophagus is large, your child may need to wait a few months for the operation, to allow their oesophagus to grow a bit more. […] Occasionally, a procedure to lengthen the oesophagus before repairing it may be carried out.

• #23 Esophageal Atresia in Children: Diagnosis and Treatment

  https://www.massgeneral.org/children/esophageal-atresia/diagnosis-and-treatment

  The outcomes between open and thoracoscopic repairs are similar. On average, children who have thoracoscopic surgery spend fewer days on narcotics (prescription pain medicines) and feeding tubes. […] Esophageal atresia treatment methods have greatly improved over the past several decades. Now, babies born with esophageal atresia are expected to live well into adulthood if their condition continues to be managed properly.

• #24 Tracheoesophageal Fistula and Esophageal Atresia | Children’s Hospital Los Angeles

  https://www.chla.org/tracheoesophageal-fistula

  Babies receive treatment for TEFs after they are born. Our specialists from the Fetal-Maternal Center will closely monitor you and your baby throughout pregnancy, working with you to carefully plan your delivery and outline an appropriate care plan and treatment options for your baby. […] For TEF with or without EA, your baby will have neonatal surgery within 48 hours after birth. Surgery for TEF helps prevent damage from food, fluids, saliva or mucus secretions that can get into the lungs. […] The type of surgery depends on your babys overall health and the type of TEF: TEF Without EA: Surgeons can usually repair the TEF in one surgery. They remove the connection between the trachea and esophagus. They also repair each structure so that your baby can swallow, eat, and breathe normally.

• #25 Tracheoesophageal Fistula and Esophageal Atresia | Children’s Hospital Los Angeles

  https://www.chla.org/tracheoesophageal-fistula

  TEF With EA: In addition to closing the TEF, surgeons create a continuous esophagus from the throat to the stomach by connecting its two sections. If they are too far apart, your baby might need two surgeries, allowing time for the sections to grow. […] The outlook for TEF surgery is promising, with many children experiencing successful outcomes that enable them to achieve adequate nutrition and thrive, especially with proper medical support. Post-surgery, these children often adapt well, allowing for normal esophageal function and improved nutrition through oral feeding. […] However, although surgery is generally a success, potential complications may include scar tissue at the surgical site that results in a narrowed esophagus or the development of gastrointestinal reflux disease (GERD). Discuss potential outcomes with your care provider when evaluating your child’s options for surgical repair. Some children may require additional surgery or follow-up care months after surgery, particularly if complications arise or if the esophagus requires reconstructive surgery. Regular follow-up visits with the CHLA specialty team are vital to monitor long-term growth, respiratory health, and address potential complications like gastroesophageal reflux.

• #26 Tracheoesophageal Fistula and Esophageal Atresia | Children’s Hospital Los Angeles

  https://www.chla.org/tracheoesophageal-fistula

  Babies receive treatment for TEFs after they are born. Our specialists from the Fetal-Maternal Center will closely monitor you and your baby throughout pregnancy, working with you to carefully plan your delivery and outline an appropriate care plan and treatment options for your baby. […] For TEF with or without EA, your baby will have neonatal surgery within 48 hours after birth. Surgery for TEF helps prevent damage from food, fluids, saliva or mucus secretions that can get into the lungs. […] The type of surgery depends on your babys overall health and the type of TEF: TEF Without EA: Surgeons can usually repair the TEF in one surgery. They remove the connection between the trachea and esophagus. They also repair each structure so that your baby can swallow, eat, and breathe normally.

• #27 Management of congenital isolated H-type tracheoesophageal fistula – Durakbasa – Current Challenges in Thoracic Surgery

  https://ccts.amegroups.org/article/view/46142/html

  The treatment is surgical. Surgery is usually performed by a lateral cervical approach especially if the level of the fistula is at or above the T2 vertebra level. More caudal fistulas are usually approached either by thoracotomy or thoracoscopy. […] Operative correction can be achieved by lateral cervical or thoracic approaches. The accurate estimation of the level of the fistula is essential to a satisfactory approach. Most congenital H-type TEF are characteristically rather high. It is near or above the thoracic outlet in many cases. Following the first successful repair of H-type TEF in 1939, a thoracic approach by thoracotomy was favored by many surgeons. […] The coupling of the surgery with endoscopic investigation which allows fistula catheterization is highly recommended if not considered mandatory.

• #28

  https://link.springer.com/article/10.1007/s003830050310

  Recurrent tracheo-oesophageal fistula (RTOF) occurs in 5%15% of patients following oesophageal atresia repair. […] Endoscopic occlusion of the RTOF with tissue adhesives (fibrin glue, Histoacryl) is reported to be safe and highly effective. […] Overall, only 55% of these endoscopically treated fistulas remained closed long-term. […] Fistula recurrence invariably occurred within 12months of successful therapy (median 46days, range9335). […] Most patients required multiple endoscopic procedures to achieve successful RTOF closure (median 2.0, range14 attempts), although significantly fewer attempts were required with fibrin glue therapy. […] Endoscopic therapy offers a safe and elegant alternative to high-risk surgery in the sick child, although repeated treatments may be required for successful RTOF closure.

• #29 Tracheoesophageal Fistula and Esophageal Atresia Treatments | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/gastroenterology/tracheoesophageal-fistula/treatments

  The treatment for both tracheoesophageal fistula and esophageal atresia is surgery. For a tracheoesophageal fistula, the physician will close up the opening surgically. For esophageal atresia, the physician will connect the two parts of the esophagus. Often, a second surgery is needed as your child grows. […] Both of these conditions require surgery to correct the problem.

• #30 Tracheoesophageal Fistula | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/tracheoesophageal-fistula

  Surgeons at Boston Children’s Hospital have developed highly successful techniques for treating TEF and recurrent TEF that do not result in further recurrence. […] If your baby has TEF without esophageal atresia (EA), we can usually repair it in the first day or two of life with one short operation. […] If your child has TEF with EA, our doctors will follow the same approach as above and then connect the two ends of the esophagus together, if they are close enough together to do so. […] If this is not possible, our surgeons will discuss the best options to grow the esophagus long enough for the repair. […] If your child has TEF and long-gap EA, meaning that the two disconnected ends of the esophagus are far apart, they will require a special treatment known as the Foker process. […] Children who undergo these surgical procedures usually do very well.

• #31 Tracheoesophageal fistula and esophageal atresia repair Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/surgery/tracheoesophageal-fistula-and-esophageal-atresia-repair

  Tracheoesophageal fistula and esophageal atresia repair is surgery to repair two birth defects in the esophagus and trachea. The defects usually occur together. This surgery is almost always done soon after birth. Both defects can often be repaired at the same time. Briefly, the surgery takes place this way: Medicine (anesthesia) is given so that the baby is in a deep sleep and pain-free during surgery. The surgeon makes a cut on the side of the chest between the ribs. The fistula between the esophagus and windpipe is closed. The upper and lower portions of the esophagus are sewn together if possible. […] Tracheoesophageal fistula and esophageal atresia are life-threatening problems. They need to be treated right away. If these problems are not treated: Your child may breathe saliva and fluids from the stomach into the lungs. This is called aspiration. It can cause choking and pneumonia (lung infection). Your child cannot swallow and digest at all if the esophagus does not connect to the stomach.

• #32 Tracheoesophageal Fistula and Esophageal Atresia Treatments | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/gastroenterology/tracheoesophageal-fistula/treatments

  The treatment for both tracheoesophageal fistula and esophageal atresia is surgery. For a tracheoesophageal fistula, the physician will close up the opening surgically. For esophageal atresia, the physician will connect the two parts of the esophagus. Often, a second surgery is needed as your child grows. […] Both of these conditions require surgery to correct the problem.

• #33 Tracheoesophageal Fistula and Esophageal Atresia Treatments | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/gastroenterology/tracheoesophageal-fistula/treatments

  The treatment for both tracheoesophageal fistula and esophageal atresia is surgery. For a tracheoesophageal fistula, the physician will close up the opening surgically. For esophageal atresia, the physician will connect the two parts of the esophagus. Often, a second surgery is needed as your child grows. […] Both of these conditions require surgery to correct the problem.

• #34 Guidelines for treatment of esophageal atresia in the …

  https://ppch.pl/seo/article/01.3001.0015.8208/en

  Management of long-gap EA: According to ERNICA, the definition of long-gap EA is “any EA with a gap of three vertebral bodies or more.” […] The preferred method of treatment is delayed primary anastomosis, best to be performed at the age of 2–3 months. […] According to INoEA, the viable option is jejunal interposition, which allows intrinsic motility and causes less pulmonary complications than other replacement techniques. […] Postoperative management: At first feeding takes place via the transanastomotic tube. […] According to ERNICA it can be routinely initiated at 24 hours. […] There is no need for a routinely performed contrast study before oral feeding. […] Acid suppression is a very important part of hospital treatment. […] Before discharge the abdominal and renal ultrasound should be performed.

• #35 Guidelines for treatment of esophageal atresia in the …

  https://ppch.pl/seo/article/01.3001.0015.8208/en

  Management of long-gap EA: According to ERNICA, the definition of long-gap EA is “any EA with a gap of three vertebral bodies or more.” […] The preferred method of treatment is delayed primary anastomosis, best to be performed at the age of 2–3 months. […] According to INoEA, the viable option is jejunal interposition, which allows intrinsic motility and causes less pulmonary complications than other replacement techniques. […] Postoperative management: At first feeding takes place via the transanastomotic tube. […] According to ERNICA it can be routinely initiated at 24 hours. […] There is no need for a routinely performed contrast study before oral feeding. […] Acid suppression is a very important part of hospital treatment. […] Before discharge the abdominal and renal ultrasound should be performed.

• #36 Oesophageal atresia and tracheo-oesophageal fistula

  https://www.nhs.uk/conditions/oesophageal-atresia/

  An operation to repair an oesophageal atresia and tracheo-oesophageal fistula is usually done soon after birth. […] Your baby will be taken to the neonatal intensive care unit, where they’re given a general anaesthetic. […] They’ll receive nutrition into a vein (intravenously) and a suction tube will be used to remove fluid from the pouch in their oesophagus. […] The surgeon makes a cut on the right side of the chest, between the ribs, and closes off the abnormal connection (fistula) between the oesophagus and windpipe. They’ll then sew together the upper and lower parts of the oesophagus. […] If the gap in the oesophagus is large, your child may need to wait a few months for the operation, to allow their oesophagus to grow a bit more. […] Occasionally, a procedure to lengthen the oesophagus before repairing it may be carried out.

• #37 Oesophageal atresia and tracheo‐oesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2672849/

  Immediate surgical management involves formation of a gastrostomy for feeding and regular suctioning of the blind upper pouch to protect the airway. […] Options for reconstruction include delayed primary repair using the native oesophagus or replacement using isolated colon or stomach (gastric tube or transposition). […] Many paediatric surgeons believe that the oesophagus grows, and, with maturation, a delayed primary anastomosis can be achieved. […] Htype fistulae are usually detected later in infancy or childhood as there is no discontinuity of the oesophagus, and the child is able to feed. […] Operation is performed by a neck dissection to expose the anomaly where the fistula is divided and repaired. […] Improved survival for patients with OA has led to a greater appreciation of long term morbidity.

• #38 Esophageal Atresia > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/tracheoesophageal-fistula-and-esophageal-atresia

  A gastrostomy tube goes through the abdominal wall and allows the baby to receive feedings directly into the stomach until the two ends of the esophagus grow closer, which typically happens within a few months of birth. […] Babies will need to be fed intravenously or through a tube into the stomach until after surgical correction and while the esophagus is healing. […] Some children with esophageal atresia or TE fistula develop a narrowing (stricture) at the spot where the esophagus has been repaired. This may cause difficulty swallowing liquids or solids, leaving the baby at risk for choking. […] Treatment involves surgically stretching of the stricture. […] Children with esophageal atresia may have several other challenges, including tracheomalacia (a floppy airway), gastroesophageal reflux and/or esophageal motility issues, all of which are managed in the long term by Yale Medicine’s multidisciplinary team.

• #39 Esophageal Atresia | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/esophageal-atresia

  Multiple surgical treatments are available for children with EA, EA/TEF or long-gap EA. […] Your child’s treatment plan may include one or more of the following procedures: […] The Foker process. This groundbreaking technique stimulates the upper and lower ends of the esophagus to make them grow inside your baby, allowing them to then be joined together after several days or weeks. […] The minimally invasive Foker process. For some children, a new minimally invasive version of the Foker process may be an option. […] Static internal traction. Your baby may benefit from this procedure, which provides some esophageal growth and can shorten the time your baby must spend under anesthesia. […] Dynamic internal traction. This is another method of growing the esophagus that may be applicable in some situations to shorten the time your baby must spend under anesthesia.

• #40 Esophageal Atresia | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/esophageal-atresia

  Primary anastomosis. This surgical procedure connects the esophageal gap. […] Jejunal interposition. If the Foker process isn’t right for your child, jejunal interposition may be an option. […] Because children with EA are at higher risk for experiencing acid reflux, Barrett’s esophagus (a precancerous condition) and other concerns, they should undergo follow-up endoscopy at least once after surgical repair, as well as if they develop new or worsening symptoms. […] The best treatment for EA is usually surgery to reconnect the two ends of the baby’s esophagus to each other. […] The revolutionary Foker process encourages natural growth and lengthening of a child’s existing esophagus with the end result being an intact esophagus.

• #41 Esophageal Atresia | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/esophageal-atresia

  Multiple surgical treatments are available for children with EA, EA/TEF or long-gap EA. […] Your child’s treatment plan may include one or more of the following procedures: […] The Foker process. This groundbreaking technique stimulates the upper and lower ends of the esophagus to make them grow inside your baby, allowing them to then be joined together after several days or weeks. […] The minimally invasive Foker process. For some children, a new minimally invasive version of the Foker process may be an option. […] Static internal traction. Your baby may benefit from this procedure, which provides some esophageal growth and can shorten the time your baby must spend under anesthesia. […] Dynamic internal traction. This is another method of growing the esophagus that may be applicable in some situations to shorten the time your baby must spend under anesthesia.

• #42 Oesophageal atresia and tracheo‐oesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2672849/

  Immediate surgical management involves formation of a gastrostomy for feeding and regular suctioning of the blind upper pouch to protect the airway. […] Options for reconstruction include delayed primary repair using the native oesophagus or replacement using isolated colon or stomach (gastric tube or transposition). […] Many paediatric surgeons believe that the oesophagus grows, and, with maturation, a delayed primary anastomosis can be achieved. […] Htype fistulae are usually detected later in infancy or childhood as there is no discontinuity of the oesophagus, and the child is able to feed. […] Operation is performed by a neck dissection to expose the anomaly where the fistula is divided and repaired. […] Improved survival for patients with OA has led to a greater appreciation of long term morbidity.

• #43 Esophageal Atresia | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/esophageal-atresia

  Multiple surgical treatments are available for children with EA, EA/TEF or long-gap EA. […] Your child’s treatment plan may include one or more of the following procedures: […] The Foker process. This groundbreaking technique stimulates the upper and lower ends of the esophagus to make them grow inside your baby, allowing them to then be joined together after several days or weeks. […] The minimally invasive Foker process. For some children, a new minimally invasive version of the Foker process may be an option. […] Static internal traction. Your baby may benefit from this procedure, which provides some esophageal growth and can shorten the time your baby must spend under anesthesia. […] Dynamic internal traction. This is another method of growing the esophagus that may be applicable in some situations to shorten the time your baby must spend under anesthesia.

• #44 Esophageal Atresia | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/esophageal-atresia

  Primary anastomosis. This surgical procedure connects the esophageal gap. […] Jejunal interposition. If the Foker process isn’t right for your child, jejunal interposition may be an option. […] Because children with EA are at higher risk for experiencing acid reflux, Barrett’s esophagus (a precancerous condition) and other concerns, they should undergo follow-up endoscopy at least once after surgical repair, as well as if they develop new or worsening symptoms. […] The best treatment for EA is usually surgery to reconnect the two ends of the baby’s esophagus to each other. […] The revolutionary Foker process encourages natural growth and lengthening of a child’s existing esophagus with the end result being an intact esophagus.

• #45 Tracheoesophageal fistula and esophageal atresia repair Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/surgery/tracheoesophageal-fistula-and-esophageal-atresia-repair

  After surgery, your child will be cared for in the hospital’s NICU. Additional treatments after surgery usually include: Antibiotics as needed, to prevent infection. Breathing machine (ventilator). Chest tube (a tube through the skin into the chest wall) to drain air and fluids from the space between the outside of the lung and the inside of the chest cavity. Intravenous (IV) fluids, including nutrition. Oxygen. Pain medicines as needed. […] Surgery can usually repair a TEF and EA. Once healing from the surgery is complete, your child may have these problems: The part of the esophagus that was repaired may become narrower. Your child may need to have more surgery to treat this. Your child may have heartburn, or gastroesophageal reflux disease (GERD). This occurs when acid from the stomach goes up into the esophagus. GERD may cause breathing problems.

• #46 Oesophageal atresia and tracheo-oesophageal fistula

  https://www.nhs.uk/conditions/oesophageal-atresia/

  After surgery, your child will be kept in the intensive care unit and placed in an incubator. […] Your baby will be given nutrition intravenously at first, but you should be able to feed them after a few days using a feeding tube passed into their stomach through their nose. […] With any surgery, there’s a small risk of bleeding and infection. […] For this particular operation, the additional risks are: food or air leaking from the area being repaired, narrowing of the repaired oesophagus, reopening of the fistula between the oesophagus and windpipe. […] A further procedure or operation may be needed to treat these problems if they develop. […] Most children who have surgery will go on to have normal lives. […] Your child will be continuously monitored by specialists after their operation to pick up problems such as these and treat them early on.

• #47 Tracheoesophageal Fistula and Esophageal Atresia – Seattle Children’s

  https://www.seattlechildrens.org/conditions/tef-and-ea/

  After surgery for TEF/EA or EA, your baby will likely need a machine to help them breathe (ventilator). […] About a week after your babys surgery, we will do an imaging study to check the esophagus repair for leaks. […] After surgery, we will give your child pain medicine for their comfort. […] Our nutritionists keep a careful watch on your baby to be sure they are growing well. […] Our Tracheoesophageal Fistula and Esophageal Atresia Program team, including specialists in pulmonology, gastroenterology, otolaryngology, nutrition and feeding, will give your child the follow-up care they need. […] We provide ongoing support and resources for you and your child.

• #48 Tracheoesophageal fistula and esophageal atresia repair Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/surgery/tracheoesophageal-fistula-and-esophageal-atresia-repair

  After surgery, your child will be cared for in the hospital’s NICU. Additional treatments after surgery usually include: Antibiotics as needed, to prevent infection. Breathing machine (ventilator). Chest tube (a tube through the skin into the chest wall) to drain air and fluids from the space between the outside of the lung and the inside of the chest cavity. Intravenous (IV) fluids, including nutrition. Oxygen. Pain medicines as needed. […] Surgery can usually repair a TEF and EA. Once healing from the surgery is complete, your child may have these problems: The part of the esophagus that was repaired may become narrower. Your child may need to have more surgery to treat this. Your child may have heartburn, or gastroesophageal reflux disease (GERD). This occurs when acid from the stomach goes up into the esophagus. GERD may cause breathing problems.

• #49 Oesophageal atresia with tracheo-oesophageal fistula | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/oesophageal-atresia-tracheo-oesophageal-fistula/

  After the operation, the join may leak or it may narrow over time, but these can both be treated in another operation. […] Your baby will be transferred to a surgical ward at GOSH when he or she no longer needs intensive care. While your babys intestines recover and start to work, he or she will have an intravenous drip of fluids. Feeding usually starts a few days after the operation, with breast or bottled milk given through a naso-gastric tube. […] Some children also complain of problems with swallowing and need to have a drink with all food. This is often caused by the oesophagus not being coordinated but it can be investigated by a speech and language therapist, who can suggest treatment (sometimes involving surgery) and exercises. […] In many cases, we start babies on an anti-reflux medicine after the operation to reduce the risk of this developing.

• #50 Tracheoesophageal Fistula and Esophageal Atresia – Seattle Children’s

  https://www.seattlechildrens.org/conditions/tef-and-ea/

  After surgery for TEF/EA or EA, your baby will likely need a machine to help them breathe (ventilator). […] About a week after your babys surgery, we will do an imaging study to check the esophagus repair for leaks. […] After surgery, we will give your child pain medicine for their comfort. […] Our nutritionists keep a careful watch on your baby to be sure they are growing well. […] Our Tracheoesophageal Fistula and Esophageal Atresia Program team, including specialists in pulmonology, gastroenterology, otolaryngology, nutrition and feeding, will give your child the follow-up care they need. […] We provide ongoing support and resources for you and your child.

• #51 Esophageal Atresia With or Without Tracheoesophageal Fistula Treatment & Management: Approach Considerations, Indications for and Timing of Surgical Intervention, Options for Surgery

  https://emedicine.medscape.com/article/935858-treatment

  Surgical techniques vary according to surgeons’ preferences and variations in pathologic anatomy. […] With further study, esophageal tissue engineering and esophageal transplantation may offer additional viable options for esophageal replacement in the future. […] In a number of pediatric surgical centers, surgeons repair esophageal atresia via a minimally invasive thoracoscopic approach. […] Many reports have described operative techniques and outcomes of such repairs in esophageal atresia and esophageal atresia with TEF. […] Robotic assistance has also been applied to thoracoscopic esophageal repairs in this population. […] The intubated patient is transported to the neonatal intensive care unit (NICU). […] Antibiotics are continued until the chest drain is removed. […] The chest draining tube is placed in 2 cm of water only to seal it; it is not connected to a suction device, which could encourage an anastomotic leak.

• #52 Esophageal Atresia With or Without Tracheoesophageal Fistula Treatment & Management: Approach Considerations, Indications for and Timing of Surgical Intervention, Options for Surgery

  https://emedicine.medscape.com/article/935858-treatment

  The surgeon should be alert for any saliva exiting out the chest drain; this is a signal of anastomotic leakage. […] Early complications may include anastomotic leakage, recurrent TEF, and anastomotic stricture. […] An anastomotic leak tends to occur 3-4 days after surgery. […] Recurrent TEF may occur within days; most often, it occurs weeks later. […] Anastomotic stricture has been reported in as many as 50% of cases, but the rate partially depends on the definition of stricture. […] Late complications may include GER, esophageal dysmotility, and tracheomalacia. […] All babies with esophageal atresia should be prophylactically treated with ranitidine or a PPI (eg, omeprazole). […] Surgical approaches to helping the child may include an antireflux operation.

• #53 Esophageal Atresia | UCSF Department of Surgery

  https://pedsurg.ucsf.edu/condition/esophageal-atresia

  To prevent this irritation, your baby will be started on an antacid medication and a medication to enhance stomach emptying. These medications are continued after hospital discharge for as long as needed, with dosages adjusted by your pediatrician as your child gains weight. Please do not stop these medications without consulting your child’s surgeon. […] Surgical dilation (stretching) of the esophageal stricture may be required and will be performed under anesthesia.

• #54 Tracheoesophageal Fistula and Esophageal Atresia – Seattle Children’s

  https://www.seattlechildrens.org/conditions/tef-and-ea/

  After surgery for TEF/EA or EA, your baby will likely need a machine to help them breathe (ventilator). […] About a week after your babys surgery, we will do an imaging study to check the esophagus repair for leaks. […] After surgery, we will give your child pain medicine for their comfort. […] Our nutritionists keep a careful watch on your baby to be sure they are growing well. […] Our Tracheoesophageal Fistula and Esophageal Atresia Program team, including specialists in pulmonology, gastroenterology, otolaryngology, nutrition and feeding, will give your child the follow-up care they need. […] We provide ongoing support and resources for you and your child.

• #55 Oesophageal atresia with tracheo-oesophageal fistula | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/oesophageal-atresia-tracheo-oesophageal-fistula/

  After the operation, the join may leak or it may narrow over time, but these can both be treated in another operation. […] Your baby will be transferred to a surgical ward at GOSH when he or she no longer needs intensive care. While your babys intestines recover and start to work, he or she will have an intravenous drip of fluids. Feeding usually starts a few days after the operation, with breast or bottled milk given through a naso-gastric tube. […] Some children also complain of problems with swallowing and need to have a drink with all food. This is often caused by the oesophagus not being coordinated but it can be investigated by a speech and language therapist, who can suggest treatment (sometimes involving surgery) and exercises. […] In many cases, we start babies on an anti-reflux medicine after the operation to reduce the risk of this developing.

• #56 Oesophageal atresia and tracheo-oesophageal fistula

  https://www.nhs.uk/conditions/oesophageal-atresia/

  After surgery, your child will be kept in the intensive care unit and placed in an incubator. […] Your baby will be given nutrition intravenously at first, but you should be able to feed them after a few days using a feeding tube passed into their stomach through their nose. […] With any surgery, there’s a small risk of bleeding and infection. […] For this particular operation, the additional risks are: food or air leaking from the area being repaired, narrowing of the repaired oesophagus, reopening of the fistula between the oesophagus and windpipe. […] A further procedure or operation may be needed to treat these problems if they develop. […] Most children who have surgery will go on to have normal lives. […] Your child will be continuously monitored by specialists after their operation to pick up problems such as these and treat them early on.

• #57 The treatment strategy for tracheoesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4700364/

  With the development of endoscopic techniques, the treatment of tracheoesophageal fistula (TEF) has made marked progress. […] Bronchoscopic intervention provides a good choice to palliate symptoms and reconstruct the airway and esophagus. […] The main treatments for TEF are as follow: (I) interventional treatment with bronchoscopy and endoscopy are the primary therapeutic options, which can alleviate symptoms and prolong survival; (II) surgery, which is performed rarely on patients with benign TEF (bTEF) because of the risk and the difficulty. […] Currently, the treatment of TEF is predominantly interventional and not surgical. […] The main techniques are: (I) esophageal and/or airway stenting, which is effective to seal the fistula and prevent the leakage of liquid or gas. […] Taken together, esophageal and/or airway stenting via endoscopic techniques is by far the optimal clinical option.

• #58

  https://link.springer.com/article/10.1007/s003830050310

  Recurrent tracheo-oesophageal fistula (RTOF) occurs in 5%15% of patients following oesophageal atresia repair. […] Endoscopic occlusion of the RTOF with tissue adhesives (fibrin glue, Histoacryl) is reported to be safe and highly effective. […] Overall, only 55% of these endoscopically treated fistulas remained closed long-term. […] Fistula recurrence invariably occurred within 12months of successful therapy (median 46days, range9335). […] Most patients required multiple endoscopic procedures to achieve successful RTOF closure (median 2.0, range14 attempts), although significantly fewer attempts were required with fibrin glue therapy. […] Endoscopic therapy offers a safe and elegant alternative to high-risk surgery in the sick child, although repeated treatments may be required for successful RTOF closure.

• #59 The treatment strategy for tracheoesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4700364/

  With the development of endoscopic techniques, the treatment of tracheoesophageal fistula (TEF) has made marked progress. […] Bronchoscopic intervention provides a good choice to palliate symptoms and reconstruct the airway and esophagus. […] The main treatments for TEF are as follow: (I) interventional treatment with bronchoscopy and endoscopy are the primary therapeutic options, which can alleviate symptoms and prolong survival; (II) surgery, which is performed rarely on patients with benign TEF (bTEF) because of the risk and the difficulty. […] Currently, the treatment of TEF is predominantly interventional and not surgical. […] The main techniques are: (I) esophageal and/or airway stenting, which is effective to seal the fistula and prevent the leakage of liquid or gas. […] Taken together, esophageal and/or airway stenting via endoscopic techniques is by far the optimal clinical option.

• #60 The treatment strategy for tracheoesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4700364/

  Esophageal stenting alone is a good choice to close the fistula orifice in the lower esophagus of TEF patients, especially for those with esophageal stenosis but without airway stenosis. […] Double stenting of the trachea and esophagus is recommended under some conditions. […] In patients where esophageal stents are not indicated or are unable to be placed, airway stenting alone should be considered. […] The ideal stent should meet the following requirement: (I) cover the fistula orifice completely and fit perfectly in the tracheal wall; (II) press firmly against the tracheal wall to prevent dislocation. […] Airway stenting has become the most effective palliative treatment method. […] The therapy of TEF is always a challenge in medicine. […] By far, closure of the fistula with stenting is the ideal method.

• #61 The treatment strategy for tracheoesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4700364/

  According to our results, double stenting of the trachea and esophagus can achieve the best clinical benefit. […] The closure effect of airway stent is associated with various factors. […] Therefore, the key to achieve better clinical efficacy is selecting the appropriate stent type, choice and placement of the stent dependent upon the individual patients, and combining with esophageal stenting as possible. […] Although the efficacy has been achieved after application of interventional therapy, the treatment strategy should be improved continuously to make the patients live a better and longer time.

• #62

  https://link.springer.com/article/10.1007/s003830050310

  Recurrent tracheo-oesophageal fistula (RTOF) occurs in 5%15% of patients following oesophageal atresia repair. […] Endoscopic occlusion of the RTOF with tissue adhesives (fibrin glue, Histoacryl) is reported to be safe and highly effective. […] Overall, only 55% of these endoscopically treated fistulas remained closed long-term. […] Fistula recurrence invariably occurred within 12months of successful therapy (median 46days, range9335). […] Most patients required multiple endoscopic procedures to achieve successful RTOF closure (median 2.0, range14 attempts), although significantly fewer attempts were required with fibrin glue therapy. […] Endoscopic therapy offers a safe and elegant alternative to high-risk surgery in the sick child, although repeated treatments may be required for successful RTOF closure.

• #63 Endoscopic treatment of tracheoesophageal fistula – Kiyan – Current Challenges in Thoracic Surgery

  https://ccts.amegroups.org/article/view/51188/html

  The most common approach among these surgical techniques is open thoracotomy, which bears significant technical difficulties in the previously operated areas, has a high rate of morbidity, and may occasionally cause death. […] Although not the standard method of treatment, after the first report by Gdanietz et al. in 1974, endoscopic approach for management of RTEF has gained increased popularity and many case reports, case series and reviews are published in the literature thereafter. […] Main advantage of endoscopic treatment (ET) is that it is less invasive and therefore can be better tolerated by the patients. […] The success rate of ET is lower than that of ST. […] If the literature regarding ET for TEF repair is reviewed, to make some conclusions for this relatively new method, certain obstacles were observed.

• #64 Endoscopic treatment of tracheoesophageal fistula – Kiyan – Current Challenges in Thoracic Surgery

  https://ccts.amegroups.org/article/view/51188/html

  Surgical treatment (ST) is the classical method of treatment of both congenital and recurrent tracheoesophageal fistula (RTEF). […] Endoscopic treatment (ET) of RTEF has been reported with an increased frequency in the literature. […] Although ET is reported to be used for all types of tracheoesophageal fistula (TEF) in different reports, its use is rather accepted in cases with RTEF. […] ET is an easy, less expensive and less invasive method and has low complication rates when compared to ST. […] In conclusion, ET is a promising alternative method for the management of RTEF, with an increased popularity. Thus, it can be performed as the first line therapy of the RTEF. Patients with failed endoscopic management should be managed surgically immediately. […] The conventional method for these patients is ST.

• #65 Endoscopic treatment of tracheoesophageal fistula – Kiyan – Current Challenges in Thoracic Surgery

  https://ccts.amegroups.org/article/view/51188/html

  After all these experiences of endoscopic approach to RTEF, ET is advocated as an alternative to ST. […] But among the different techniques no definitive technique is proven and accepted as the standard method. […] In conclusion, ET of RTEF is a technically easy, less invasive, less expensive method of treatment with fewer complications if compared to ST. […] Despite these disadvantages, ET is a strong alternative to ST in the management of RTEF in the future.

• #66 Oesophageal atresia and tracheo-oesophageal fistula

  https://www.nhs.uk/conditions/oesophageal-atresia/

  After surgery, your child will be kept in the intensive care unit and placed in an incubator. […] Your baby will be given nutrition intravenously at first, but you should be able to feed them after a few days using a feeding tube passed into their stomach through their nose. […] With any surgery, there’s a small risk of bleeding and infection. […] For this particular operation, the additional risks are: food or air leaking from the area being repaired, narrowing of the repaired oesophagus, reopening of the fistula between the oesophagus and windpipe. […] A further procedure or operation may be needed to treat these problems if they develop. […] Most children who have surgery will go on to have normal lives. […] Your child will be continuously monitored by specialists after their operation to pick up problems such as these and treat them early on.

• #67 Tracheoesophageal fistula and esophageal atresia repair Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/surgery/tracheoesophageal-fistula-and-esophageal-atresia-repair

  After surgery, your child will be cared for in the hospital’s NICU. Additional treatments after surgery usually include: Antibiotics as needed, to prevent infection. Breathing machine (ventilator). Chest tube (a tube through the skin into the chest wall) to drain air and fluids from the space between the outside of the lung and the inside of the chest cavity. Intravenous (IV) fluids, including nutrition. Oxygen. Pain medicines as needed. […] Surgery can usually repair a TEF and EA. Once healing from the surgery is complete, your child may have these problems: The part of the esophagus that was repaired may become narrower. Your child may need to have more surgery to treat this. Your child may have heartburn, or gastroesophageal reflux disease (GERD). This occurs when acid from the stomach goes up into the esophagus. GERD may cause breathing problems.

• #68 Esophageal Atresia With or Without Tracheoesophageal Fistula Treatment & Management: Approach Considerations, Indications for and Timing of Surgical Intervention, Options for Surgery

  https://emedicine.medscape.com/article/935858-treatment

  The surgeon should be alert for any saliva exiting out the chest drain; this is a signal of anastomotic leakage. […] Early complications may include anastomotic leakage, recurrent TEF, and anastomotic stricture. […] An anastomotic leak tends to occur 3-4 days after surgery. […] Recurrent TEF may occur within days; most often, it occurs weeks later. […] Anastomotic stricture has been reported in as many as 50% of cases, but the rate partially depends on the definition of stricture. […] Late complications may include GER, esophageal dysmotility, and tracheomalacia. […] All babies with esophageal atresia should be prophylactically treated with ranitidine or a PPI (eg, omeprazole). […] Surgical approaches to helping the child may include an antireflux operation.

• #69 Esophageal Atresia With or Without Tracheoesophageal Fistula Treatment & Management: Approach Considerations, Indications for and Timing of Surgical Intervention, Options for Surgery

  https://emedicine.medscape.com/article/935858-treatment

  The surgeon should be alert for any saliva exiting out the chest drain; this is a signal of anastomotic leakage. […] Early complications may include anastomotic leakage, recurrent TEF, and anastomotic stricture. […] An anastomotic leak tends to occur 3-4 days after surgery. […] Recurrent TEF may occur within days; most often, it occurs weeks later. […] Anastomotic stricture has been reported in as many as 50% of cases, but the rate partially depends on the definition of stricture. […] Late complications may include GER, esophageal dysmotility, and tracheomalacia. […] All babies with esophageal atresia should be prophylactically treated with ranitidine or a PPI (eg, omeprazole). […] Surgical approaches to helping the child may include an antireflux operation.

• #70 Esophageal Atresia With or Without Tracheoesophageal Fistula Treatment & Management: Approach Considerations, Indications for and Timing of Surgical Intervention, Options for Surgery

  https://emedicine.medscape.com/article/935858-treatment

  The surgeon should be alert for any saliva exiting out the chest drain; this is a signal of anastomotic leakage. […] Early complications may include anastomotic leakage, recurrent TEF, and anastomotic stricture. […] An anastomotic leak tends to occur 3-4 days after surgery. […] Recurrent TEF may occur within days; most often, it occurs weeks later. […] Anastomotic stricture has been reported in as many as 50% of cases, but the rate partially depends on the definition of stricture. […] Late complications may include GER, esophageal dysmotility, and tracheomalacia. […] All babies with esophageal atresia should be prophylactically treated with ranitidine or a PPI (eg, omeprazole). […] Surgical approaches to helping the child may include an antireflux operation.

• #71 Tracheoesophageal Fistula (TEF) and Esophageal Atresia (EA) – Children’s Hospital of Orange County

  https://choc.org/programs-services/pediatric-general-surgery/tracheoesophageal-fistula-esophageal-atresia/

  After surgery, your child will have a plastic tube in his or her chest to drain liquids. This tube will stay in place for a week or more. […] During recovery, your child will be safely fed with IV nutrition. About one week after surgery, your child will have a swallow study to confirm that the repaired area has healed well. […] In some cases, when a long-gap esophageal atresia is repaired, liquids can leak out at the repair site. This typically heals on its own over the course of several weeks. […] Most children with these conditions have a good prognosis and will go on to eat and grow normally. […] Some children with esophageal atresia have long-term problems that range from mild to severe. It may be hard for them to swallow foods and liquids. […] Some children may need a special procedure called dilation to widen a narrowed esophagus. Your child’s health care provider may do this while your child is under general anesthesia. Other children may need another surgery, although this is rare. Narrowing of the esophagus is typically less of an issue as your child grows.

• #72 Tracheoesophageal Fistula and Esophageal Atresia – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/tracheoesophageal-fistula-and-esophageal-atresia

  About one-half of children who had esophageal atresia repaired will have problems with GERD, or gastrointestinal reflux disease. GERD causes acid to move up into the esophagus from the stomach. […] GERD can usually be treated with medications or by a minimally invasive surgical antireflux procedure known as a fundoplication.

• #73 Esophageal Atresia and Tracheoesophageal Fistula | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/0215/p910.html

  Most neonates who undergo repair of esophageal atresia and tracheoesophageal fistula have some degree of esophageal dysmotility. […] The extent of the repair dictates the severity of subsequent complications. […] Recurrence of the tracheoesophageal fistula has been reported; recurrence requires repeat surgical correction. […] Approximately one half of patients with surgically corrected esophageal atresia develop gastroesophageal reflux disease (GERD). […] Of those who develop GERD, approximately one half respond to routine medical therapy with prokinetic agents, histamine H2 receptor blockers, or both, and one half require surgical intervention for correction.

• #74 Tracheoesophageal Fistula (TEF) and Esophageal Atresia (EA) – Children’s Hospital of Orange County

  https://choc.org/programs-services/pediatric-general-surgery/tracheoesophageal-fistula-esophageal-atresia/

  About one half of children who had surgery for esophageal atresia will develop gastrointestinal reflux disease (GERD). GERD causes acid to move up into the esophagus from the stomach. This causes a burning or painful feeling called heartburn. GERD can often be managed with medicines and, in severe cases, surgery.

• #75 Esophageal Atresia and Tracheoesophageal Fistula | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/0215/p910.html

  Most neonates who undergo repair of esophageal atresia and tracheoesophageal fistula have some degree of esophageal dysmotility. […] The extent of the repair dictates the severity of subsequent complications. […] Recurrence of the tracheoesophageal fistula has been reported; recurrence requires repeat surgical correction. […] Approximately one half of patients with surgically corrected esophageal atresia develop gastroesophageal reflux disease (GERD). […] Of those who develop GERD, approximately one half respond to routine medical therapy with prokinetic agents, histamine H2 receptor blockers, or both, and one half require surgical intervention for correction.

• #76 Oesophageal Atresia | Doctor

  https://patient.info/doctor/oesophageal-atresia

  Definitive treatment involves either creating an anastomosis between the native oesophagus segments (as described above) or using colon or stomach to enable the repair. […] Surgery is usually performed via the neck and the fistula is divided and repaired. […] Laser repair has also been used. […] After repair of oesophageal atresia in infancy, gastro-oesophageal reflux, oesophageal dysmotility and respiratory problems are common and significant oesophageal morbidity extends into adulthood. […] Management includes the use of antibiotics, physiotherapy and treatment of gastro-oesophageal reflux to minimise aspiration. […] Gastro-oesophageal reflux is very common. […] Management is using feed thickeners, H2 receptor antagonists, proton pump inhibitors and prokinetic drugs. […] Oesophageal dysmotility can be seen on manometry. It can lead to problems with swallowing and choking.

• #77 Esophageal Atresia With or Without Tracheoesophageal Fistula Treatment & Management: Approach Considerations, Indications for and Timing of Surgical Intervention, Options for Surgery

  https://emedicine.medscape.com/article/935858-treatment

  The surgeon should be alert for any saliva exiting out the chest drain; this is a signal of anastomotic leakage. […] Early complications may include anastomotic leakage, recurrent TEF, and anastomotic stricture. […] An anastomotic leak tends to occur 3-4 days after surgery. […] Recurrent TEF may occur within days; most often, it occurs weeks later. […] Anastomotic stricture has been reported in as many as 50% of cases, but the rate partially depends on the definition of stricture. […] Late complications may include GER, esophageal dysmotility, and tracheomalacia. […] All babies with esophageal atresia should be prophylactically treated with ranitidine or a PPI (eg, omeprazole). […] Surgical approaches to helping the child may include an antireflux operation.

• #78 Oesophageal atresia and tracheo‐oesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2672849/

  Management includes tailored use of antibiotics, physiotherapy, and optimal management of gastrooesophageal reflux to minimise the risk of recurrent aspiration. […] Gastrooesophageal reflux can significantly increase the risk of stricture formation, and fundoplication may ameliorate recalcitrant strictures. […] The challenge for the future is to further reduce morbidity to enable survivors and families lead normal productive lives in society.

• #79 Oesophageal Atresia | Doctor

  https://patient.info/doctor/oesophageal-atresia

  Definitive treatment involves either creating an anastomosis between the native oesophagus segments (as described above) or using colon or stomach to enable the repair. […] Surgery is usually performed via the neck and the fistula is divided and repaired. […] Laser repair has also been used. […] After repair of oesophageal atresia in infancy, gastro-oesophageal reflux, oesophageal dysmotility and respiratory problems are common and significant oesophageal morbidity extends into adulthood. […] Management includes the use of antibiotics, physiotherapy and treatment of gastro-oesophageal reflux to minimise aspiration. […] Gastro-oesophageal reflux is very common. […] Management is using feed thickeners, H2 receptor antagonists, proton pump inhibitors and prokinetic drugs. […] Oesophageal dysmotility can be seen on manometry. It can lead to problems with swallowing and choking.

• #80 Esophageal Atresia and Tracheoesophageal Fistula | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/0215/p910.html

  Most neonates who undergo repair of esophageal atresia and tracheoesophageal fistula have some degree of esophageal dysmotility. […] The extent of the repair dictates the severity of subsequent complications. […] Recurrence of the tracheoesophageal fistula has been reported; recurrence requires repeat surgical correction. […] Approximately one half of patients with surgically corrected esophageal atresia develop gastroesophageal reflux disease (GERD). […] Of those who develop GERD, approximately one half respond to routine medical therapy with prokinetic agents, histamine H2 receptor blockers, or both, and one half require surgical intervention for correction.

• #81 The International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia–tracheoesophageal fistula | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/s41575-023-00789-w

  The questions were formulated by all members of the transition guidelines working group of INoEA after three online rounds of selection. […] Each subgroup had a lead. […] Questions were based on expert opinion owing to the lack of randomized control trials and meta-analysis in this field and answered using the results of systematic literature searches. […] Three consensus meetings were held in June of 2020, 2021 and 2022 to achieve consensus and formulate all recommendations. […] The laparoscopic approach is nowadays the recommended surgical approach for anti-reflux surgery in patients with EA-TEF. […] The choice between total or partial fundoplication should be left to the preferences and expertise of surgeons. […] Endoscopic surveillance with biopsy samples is mandatory. […] The proposed timing of endoscopies should be similar to what is recommended in statement 5 for patients with stable EA-TEF.

• #82 Esophageal Atresia and Tracheoesophageal Fistula | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/0215/p910.html

  Most neonates who undergo repair of esophageal atresia and tracheoesophageal fistula have some degree of esophageal dysmotility. […] The extent of the repair dictates the severity of subsequent complications. […] Recurrence of the tracheoesophageal fistula has been reported; recurrence requires repeat surgical correction. […] Approximately one half of patients with surgically corrected esophageal atresia develop gastroesophageal reflux disease (GERD). […] Of those who develop GERD, approximately one half respond to routine medical therapy with prokinetic agents, histamine H2 receptor blockers, or both, and one half require surgical intervention for correction.

• #83 Esophageal Atresia and Tracheoesophageal Fistula – Children’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/children-s-health-issues/birth-defects-of-the-digestive-tract/esophageal-atresia-and-tracheoesophageal-fistula

  Surgery needs to be done soon after birth to establish a normal connection between the esophagus and stomach and to close the fistula. […] Before surgery to repair the defects can be done, preparations are done to prevent complications such as aspiration pneumonia. First, feedings by mouth are stopped, and a tube is placed in the upper esophagus to continuously suction saliva before it can reach the lungs. Then the infant is fed by vein (intravenously). […] Some complications may develop after surgery. Leakage and scar tissue at the site where the esophagus was reconnected are the most common problems. Many children have feeding difficulties. About half of children who have feeding difficulties develop gastroesophageal reflux (the backward movement of food and acid from the stomach into the esophagus), so doctors may give medications that suppress stomach acid to newborns who had esophageal atresia. If the medications do not control the reflux, a procedure called fundoplication is done. In fundoplication, the surgeon wraps the top of the stomach around the lower end of the esophagus to make that junction tighter and decrease reflux.

• #84 Esophageal Atresia > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/tracheoesophageal-fistula-and-esophageal-atresia

  A gastrostomy tube goes through the abdominal wall and allows the baby to receive feedings directly into the stomach until the two ends of the esophagus grow closer, which typically happens within a few months of birth. […] Babies will need to be fed intravenously or through a tube into the stomach until after surgical correction and while the esophagus is healing. […] Some children with esophageal atresia or TE fistula develop a narrowing (stricture) at the spot where the esophagus has been repaired. This may cause difficulty swallowing liquids or solids, leaving the baby at risk for choking. […] Treatment involves surgically stretching of the stricture. […] Children with esophageal atresia may have several other challenges, including tracheomalacia (a floppy airway), gastroesophageal reflux and/or esophageal motility issues, all of which are managed in the long term by Yale Medicine’s multidisciplinary team.

• #85 Oesophageal atresia and tracheo-oesophageal fistula (OA and TOF) – Royal Manchester Children’s Hospital

  https://mft.nhs.uk/rmch/services/manchester-centre-for-neonatal-surgery/conditions-we-treat-at-mcns/oesophageal-atresia-and-tracheo-oesophageal-fistula-oa-and-tof/

  All babies with OA/TOF need urgent surgery to disconnect the TOF (fistula) between the windpipe and food pipe. This will stop stomach contents from going into the lungs and air going into the stomach. […] During the operation it is often possible for the food pipe (oesophagus) to be repaired at the same time, so the baby can then feed. However, in some babies this is not possible and they might need further operations. […] An operation under a general anaesthetic will usually take place in the first day or two of life. […] If a TOF is present it will be closed/repaired. This will make it easier for the baby to breathe and protect the lungs from the contents of the stomach. […] With OA (blocked food pipe) the blocked section is removed and the two ends joined together. […] Sometimes the two ends of the food pipe do not reach each other, so a feeding tube will be put in the stomach. This is called a gastrostomy. It means your baby can feed and grow until another operation to join the two ends of the food pipe together. […] Dilation for OA/TOF is where a small balloon is passed through the narrow area of the food pipe and then gently blown up to stretch the narrow area open. This is done under general anaesthetic and your baby is usually able to go home the same day.

• #86 Tracheoesophageal Fistula and Esophageal Atresia – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=tracheoesophageal-fistula-and-esophageal-atresia-90-P02018

  Treatment will depend on your childs symptoms, age, and general health. It will also depend on how severe the condition is. If your child has one or both of these issues, they will need surgery. […] With a TE fistula, the connection between the esophagus and trachea is closed in surgery. […] Sometimes children with esophageal atresia need more than one surgery. This depends on how close the 2 tubes are to each other. Your baby’s surgeon and healthcare team will decide when your baby should have the surgeries. […] Some children may need a special test to widen a narrowed esophagus. Your childs healthcare provider may do this while your child is under general anesthesia. Other children may need another surgery. Your childs surgeon will open up the esophagus so food can pass to the stomach. […] Even after surgery, children with these conditions may have trouble swallowing well.

• #87 Oesophageal atresia and tracheo‐oesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2672849/

  Management includes tailored use of antibiotics, physiotherapy, and optimal management of gastrooesophageal reflux to minimise the risk of recurrent aspiration. […] Gastrooesophageal reflux can significantly increase the risk of stricture formation, and fundoplication may ameliorate recalcitrant strictures. […] The challenge for the future is to further reduce morbidity to enable survivors and families lead normal productive lives in society.

• #88 The International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia–tracheoesophageal fistula | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/s41575-023-00789-w

  Oesophageal atresiatracheoesophageal fistula (EA-TEF) is a common congenital digestive disease. Patients with EA-TEF face gastrointestinal, surgical, respiratory, otolaryngological, nutritional, psychological and quality of life issues in childhood, adolescence and adulthood. […] The Transition Working Group of the International Network on Oesophageal Atresia (INoEA) was charged with the task of developing uniform evidence-based guidelines for the management of complications through the transition from adolescence into adulthood. […] A systematic literature search was performed based on which recommendations were made. All recommendations were discussed and finalized during consensus meetings, and the group members voted on each recommendation. […] The list of the 42 statements, all based on expert opinion, was voted on and agreed upon. These statements addressed the diagnosis, treatment and prognosis of gastrointestinal, surgical, respiratory, otolaryngological, nutritional, psychological and QOL complications that patients with EA-TEF faced during adolescence and after the transition to adulthood.

• #89 The International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia–tracheoesophageal fistula | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/s41575-023-00789-w

  The questions were formulated by all members of the transition guidelines working group of INoEA after three online rounds of selection. […] Each subgroup had a lead. […] Questions were based on expert opinion owing to the lack of randomized control trials and meta-analysis in this field and answered using the results of systematic literature searches. […] Three consensus meetings were held in June of 2020, 2021 and 2022 to achieve consensus and formulate all recommendations. […] The laparoscopic approach is nowadays the recommended surgical approach for anti-reflux surgery in patients with EA-TEF. […] The choice between total or partial fundoplication should be left to the preferences and expertise of surgeons. […] Endoscopic surveillance with biopsy samples is mandatory. […] The proposed timing of endoscopies should be similar to what is recommended in statement 5 for patients with stable EA-TEF.

• #90 The International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia–tracheoesophageal fistula | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/s41575-023-00789-w

  Patients with stable EA-TEF should be reviewed by a gastroenterologist at least every 2 years between 18 and 34 years of age and annually from the age of 35 years onwards. […] Endoscopic surveillance with biopsy samples and narrow-band imaging, where available, should be performed every 5 years between 18 and 28 years of age, every 3 years between 28 and 40 years of age, every 2 years between 40 and 50 years of age, and annually onwards. […] Additional endoscopies are required in case of new or worsening symptoms and in accordance with the recommendations for existing Barrett oesophagus. […] Patients with EA-TEF are at risk of respiratory morbidity their entire lives. […] Adult patients with EA-TEF should have routine follow-up with a respirologist and PFT at the time of transition.

• #91 The International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia–tracheoesophageal fistula | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/s41575-023-00789-w

  Patients with stable EA-TEF should be reviewed by a gastroenterologist at least every 2 years between 18 and 34 years of age and annually from the age of 35 years onwards. […] Endoscopic surveillance with biopsy samples and narrow-band imaging, where available, should be performed every 5 years between 18 and 28 years of age, every 3 years between 28 and 40 years of age, every 2 years between 40 and 50 years of age, and annually onwards. […] Additional endoscopies are required in case of new or worsening symptoms and in accordance with the recommendations for existing Barrett oesophagus. […] Patients with EA-TEF are at risk of respiratory morbidity their entire lives. […] Adult patients with EA-TEF should have routine follow-up with a respirologist and PFT at the time of transition.

• #92 The International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia–tracheoesophageal fistula | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/s41575-023-00789-w

  Patients with stable EA-TEF should be reviewed by a gastroenterologist at least every 2 years between 18 and 34 years of age and annually from the age of 35 years onwards. […] Endoscopic surveillance with biopsy samples and narrow-band imaging, where available, should be performed every 5 years between 18 and 28 years of age, every 3 years between 28 and 40 years of age, every 2 years between 40 and 50 years of age, and annually onwards. […] Additional endoscopies are required in case of new or worsening symptoms and in accordance with the recommendations for existing Barrett oesophagus. […] Patients with EA-TEF are at risk of respiratory morbidity their entire lives. […] Adult patients with EA-TEF should have routine follow-up with a respirologist and PFT at the time of transition.

• #93 The International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia–tracheoesophageal fistula | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/s41575-023-00789-w

  Patients with stable EA-TEF should be reviewed by a gastroenterologist at least every 2 years between 18 and 34 years of age and annually from the age of 35 years onwards. […] Endoscopic surveillance with biopsy samples and narrow-band imaging, where available, should be performed every 5 years between 18 and 28 years of age, every 3 years between 28 and 40 years of age, every 2 years between 40 and 50 years of age, and annually onwards. […] Additional endoscopies are required in case of new or worsening symptoms and in accordance with the recommendations for existing Barrett oesophagus. […] Patients with EA-TEF are at risk of respiratory morbidity their entire lives. […] Adult patients with EA-TEF should have routine follow-up with a respirologist and PFT at the time of transition.

• #94 Tracheoesophageal Fistula and Esophageal Atresia – Seattle Children’s

  https://www.seattlechildrens.org/conditions/tef-and-ea/

  After surgery for TEF/EA or EA, your baby will likely need a machine to help them breathe (ventilator). […] About a week after your babys surgery, we will do an imaging study to check the esophagus repair for leaks. […] After surgery, we will give your child pain medicine for their comfort. […] Our nutritionists keep a careful watch on your baby to be sure they are growing well. […] Our Tracheoesophageal Fistula and Esophageal Atresia Program team, including specialists in pulmonology, gastroenterology, otolaryngology, nutrition and feeding, will give your child the follow-up care they need. […] We provide ongoing support and resources for you and your child.

• #95 Welcome to Esophageal Atresia Care | Columbia Surgery

  https://columbiasurgery.org/esophageal-atresia-care

  The collaborative format of the EA program also addresses an important need for patients and their families: the need to see multiple specialists for complicated, multi-system birth defects in the spectrum known as VACTERL. […] The Researching Esophageal Atresia for Children’s Health (REACH) Clinic at Columbia/NYP Morgan Stanley Children’s Hospital was founded with the following goals in mind: Provide coordinated multidisciplinary care that addresses all facets of a child’s conditions, Determine how to safely and effectively treat silent reflux and other complications associated with EA, Help older patients transition to practitioners caring for adults who are well versed in the special needs associated with EA, Conduct research to identify genetic abnormalities underlying EA and related anomalies, Conduct longitudinal clinical research in order to develop best-practice treatment protocols.

• #96 The International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia–tracheoesophageal fistula | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/s41575-023-00789-w

  Management in conjunction with a gastroenterologist is strongly recommended. […] Regular evaluation of the anastomosis should be considered as 20-40% of patients have strictures affecting normal oral consumption. […] The transition from adolescence to adult medicine is, therefore, a new challenge. […] This Consensus Statement will hopefully contribute to improved care and outcomes for adolescent and adult patients with EA-TEF.

• #97 Oesophageal Atresia | Doctor

  https://patient.info/doctor/oesophageal-atresia

  Oesophageal atresia is a congenital anatomical malformation characterised by discontinuity of the oesophagus as a result of disruptions to foregut separation during embryological development. In the majority of cases, there is a fistula between the trachea and oesophagus, called a tracheo-oesophageal fistula (TOF). […] OA is usually surgically corrected in the first few days of life, and survival rates currently exceed 90% due to advancements in surgical techniques and neonatal intensive care. […] A multidisciplinary approach involving surgeons, physiotherapists, respiratory physicians, dieticians and speech therapists is best. […] The basis of management is surgery to correct the anatomical abnormality. […] Surgery is carried out either immediately, as a delayed repair or as a staged repair depending on other factors such as birth weight and other associated conditions (principally cardiac abnormalities).

• #98 Oesophageal atresia and tracheo‐oesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2672849/

  Oesophageal atresia (OA) and tracheooesophageal fistula (TOF) has been a key domain of paediatric surgery since its early beginnings and continues to challenge specialists who care for these vulnerable children. […] With overall survival now exceeding 90% in dedicated centres, emphasis in the modern era has been on reducing morbidity and achieving improvements in the quality of life. […] An overview of current and emerging strategies in managing patients with OATOF is presented. […] Operative repair of OATOF follows well established surgical techniques. […] A right posterolateral (extrapleural) thoracotomy is performed, the fistula ligated, and primary oesophageal anastomosis created. […] Almost 60 years after the first successful primary repair, another landmark in the management of OA was achieved by Tom Lobe and Steve Rothenberg from North America when they undertook the first minimally invasive thoracoscopic repair of OATOF.

• #99 Esophageal Atresia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/21178-esophageal-atresia

  Surgery on your babys esophagus is called thoracic surgery. […] After surgery, your baby will return to the NICU to recover. […] The survival rate for babies who receive treatment and dont have other compromising conditions is near 100%. […] While most children recover well and grow to adulthood, some may have lingering side effects from the esophageal atresia and the surgery to fix it. […] You can continue to consult their healthcare team for personal advice and support.

• #100 Esophageal atresia with tracheoesophageal fistula: two case reports | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-023-04278-1

  The outcome of infants with esophageal atresia and tracheoesophageal fistula in lower middle income countries is not encouraging due to delays in referral and poor postoperative healing attributed to sepsis and recurrent pneumothorax. […] Timely referral, preoperative condition of the infant, and timely management has shown to be a contributory factor for an improved outcome. […] Management of infants with TEF in our part of the world is still challenging. […] The main treatment for TEF is surgery that can be performed with a right thoracotomy or bronchoscopy, and endoscopy is the primary therapeutic option. […] Of the two cases we present, one had an earlier diagnosis and referral and had a good outcome postoperative. […] The infant with late diagnosis and referral succumbed, and because preoperative the baby was unwell, surgery was delayed due to initial stabilization; thus, there were postoperative complications.

• #101 Esophageal Atresia and Tracheoesophageal Fistula | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/0215/p910.html

  It is also recognized that prompt diagnosis with appropriate clinical management and expeditious referral to a tertiary care center have had a dramatic impact on the improved survival of these infants. […] Once a diagnosis of esophageal atresia is established, preparations should be made for surgical correction. […] Measures should be taken to reduce the risk of aspiration. […] The infant should also be transferred to a tertiary care center with a neonatal intensive care unit. […] Healthy infants without pulmonary complications or other major anomalies usually can undergo primary repair in the first few days of life. […] Surgical repair is delayed in infants with low birth weight, pneumonia or other major anomalies. […] The survival rate in this group is lower but in the range of 80 to 95 percent.

• #102 Esophageal atresia with tracheoesophageal fistula: two case reports | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-023-04278-1

  The outcome of infants with esophageal atresia and tracheoesophageal fistula in lower middle income countries is not encouraging due to delays in referral and poor postoperative healing attributed to sepsis and recurrent pneumothorax. […] Timely referral, preoperative condition of the infant, and timely management has shown to be a contributory factor for an improved outcome. […] Management of infants with TEF in our part of the world is still challenging. […] The main treatment for TEF is surgery that can be performed with a right thoracotomy or bronchoscopy, and endoscopy is the primary therapeutic option. […] Of the two cases we present, one had an earlier diagnosis and referral and had a good outcome postoperative. […] The infant with late diagnosis and referral succumbed, and because preoperative the baby was unwell, surgery was delayed due to initial stabilization; thus, there were postoperative complications.

• #103 Tracheoesophageal Fistula Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/186735-treatment

  Transfer infants and children with tracheoesophageal fistula (TEF) to a pediatric center experienced with surgical repair of TEF. The center should be experienced with providing support of critically ill pediatric patients. […] Surgical repair is required following confirmation of a diagnosis of tracheoesophageal fistula (TEF). Note the following: In healthy infants without pulmonary complications, primary repair is performed within the first few days of life. Repair is delayed in patients with low birth weight, pneumonia, or other major anomalies. Initially, treat patients conservatively with parenteral nutrition, gastrostomy, and upper pouch suction until they are considered to be low risk. […] Because acquired TEFs do not close spontaneously, surgical repair is planned if the patient is stable enough. Critically ill patients are managed conservatively until stable enough for a major surgical procedure.

• #104 Esophageal Atresia and Tracheoesophageal Fistula: Signs, Causes & Treatment

  https://www.whattoexpect.com/first-year/tracheoesophageal-atresia-and-tracheoesophageal-fistula.aspx

  About half of babies with EA and/or TEF have other birth defects that may also need to be addressed. Congenital heart defects are among the most common, but gastrointestinal abnormalities and defects of the urogenital tract can also occur. Your babys pediatrician will determine how best to manage additional defects alongside the EA and/or TEF. […] The prospect of EA and/or TEF can be worrisome, especially because it requires surgery so shortly after birth. Working with an experienced neonatal care team can ensure your baby gets the care that she needs, so he can go on to feed and grow normally.

• #105 Oesophageal atresia and tracheo-oesophageal fistula in neonates | Safer Care Victoria

  https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/neonatal/oesophageal-atresia-and-tracheo-oesophageal-fistula-in-neonates

  Oesophageal atresia (OA) involves an interruption to the lumen of the oesophagus, with the oesophagus ending in a blind pouch. OA is usually associated with a tracheo-oesophageal fistula (TOF), which is an abnormal connection between the oesophagus and the trachea. […] Regular, thorough suctioning of the upper oesophageal pouch is required prior to definitive surgical repair. […] Referral to PIPER and a tertiary neonatal surgical unit should be made as soon as possible. […] Management of oesophageal atresia and TOF involves: If oesophageal atresia is suspected antenatally baby should be delivered close to a Level 6 surgical neonatal unit. […] The neonate must be kept nil by mouth, commenced on intravenous fluids and nursed supine in a head up position (approximately 30-60 degrees).

• #106 Oesophageal atresia and tracheo-oesophageal fistula

  https://www.nhs.uk/conditions/oesophageal-atresia/

  After surgery, your child will be kept in the intensive care unit and placed in an incubator. […] Your baby will be given nutrition intravenously at first, but you should be able to feed them after a few days using a feeding tube passed into their stomach through their nose. […] With any surgery, there’s a small risk of bleeding and infection. […] For this particular operation, the additional risks are: food or air leaking from the area being repaired, narrowing of the repaired oesophagus, reopening of the fistula between the oesophagus and windpipe. […] A further procedure or operation may be needed to treat these problems if they develop. […] Most children who have surgery will go on to have normal lives. […] Your child will be continuously monitored by specialists after their operation to pick up problems such as these and treat them early on.

• #107 Tracheoesophageal fistula and esophageal atresia repair: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/002934.htm

  Tracheoesophageal fistula and esophageal atresia repair is surgery to repair two birth defects in the esophagus and trachea. The defects usually occur together. […] This surgery is almost always done soon after birth. Both defects can often be repaired at the same time. Briefly, the surgery takes place this way: […] Often the two parts of the esophagus are too far apart to sew together right away. In this case: […] Sometimes the surgeon will wait 2 to 4 months before doing the surgery. Waiting allows your baby to grow or have other problems treated. […] Tracheoesophageal fistula and esophageal atresia are life-threatening problems. They need to be treated right away. […] After surgery, your child will be cared for in the hospital’s NICU. […] Surgery can usually repair a TEF and EA. Once healing from the surgery is complete, your child may have these problems: […] During infancy and early childhood, many children will have problems with breathing, growth, and feeding, and will need to continue seeing both their primary care provider and specialists.

• #108 Esophageal Atresia With or Without Tracheoesophageal Fistula Treatment & Management: Approach Considerations, Indications for and Timing of Surgical Intervention, Options for Surgery

  https://emedicine.medscape.com/article/935858-treatment

  If no distal TEF is present, a gastrostomy may be created. […] In cases such as those above or in cases in which a distal fistula continues to cause lung soiling, distal TEF ligation should be considered. […] A cervical esophagostomy or spit fistula may be constructed in the right or left side of the neck, depending on the choice for subsequent esophageal substitution. […] In May 2017, the US Food and Drug Administration (FDA) approved the Flourish Pediatric Esophageal Atresia Anastomosis for management of esophageal atresia in infants up to 1 year old who do not have teeth and do not have a TEF (or have had a TEF repaired). […] The device closes the gap in the esophagus by using magnets to pull together the upper and lower portions of the esophagus. […] In the future, more accurate antenatal diagnosis and antenatal treatment may be possible.

• #109 Esophageal Atresia With or Without Tracheoesophageal Fistula Treatment & Management: Approach Considerations, Indications for and Timing of Surgical Intervention, Options for Surgery

  https://emedicine.medscape.com/article/935858-treatment

  Minimally invasive techniques for repair with thoracoscopic surgery are now used in some centers, with good results. […] The management of gastroesophageal reflux (GER) in esophageal atresia is particularly challenging; some advocate aggressive fundoplication, and others prefer more conservative medical treatment. […] Tissue engineering of the esophagus may offer solutions for replacement of lost esophageal tissue. […] The indications for and timing of surgical repair may be determined by using the Waterston, Spitz, or Poenaru prognostic classification system. […] The aforementioned prognostic groupings can allow for the stratification of high-risk patients with esophageal atresia in planning for delayed repair, staged repair, or both; low-risk babies can usually undergo early primary single-stage repair.

• #110 Esophageal Atresia With or Without Tracheoesophageal Fistula Treatment & Management: Approach Considerations, Indications for and Timing of Surgical Intervention, Options for Surgery

  https://emedicine.medscape.com/article/935858-treatment

  If no distal TEF is present, a gastrostomy may be created. […] In cases such as those above or in cases in which a distal fistula continues to cause lung soiling, distal TEF ligation should be considered. […] A cervical esophagostomy or spit fistula may be constructed in the right or left side of the neck, depending on the choice for subsequent esophageal substitution. […] In May 2017, the US Food and Drug Administration (FDA) approved the Flourish Pediatric Esophageal Atresia Anastomosis for management of esophageal atresia in infants up to 1 year old who do not have teeth and do not have a TEF (or have had a TEF repaired). […] The device closes the gap in the esophagus by using magnets to pull together the upper and lower portions of the esophagus. […] In the future, more accurate antenatal diagnosis and antenatal treatment may be possible.

• #111 Esophageal Atresia With or Without Tracheoesophageal Fistula Treatment & Management: Approach Considerations, Indications for and Timing of Surgical Intervention, Options for Surgery

  https://emedicine.medscape.com/article/935858-treatment

  Surgical techniques vary according to surgeons’ preferences and variations in pathologic anatomy. […] With further study, esophageal tissue engineering and esophageal transplantation may offer additional viable options for esophageal replacement in the future. […] In a number of pediatric surgical centers, surgeons repair esophageal atresia via a minimally invasive thoracoscopic approach. […] Many reports have described operative techniques and outcomes of such repairs in esophageal atresia and esophageal atresia with TEF. […] Robotic assistance has also been applied to thoracoscopic esophageal repairs in this population. […] The intubated patient is transported to the neonatal intensive care unit (NICU). […] Antibiotics are continued until the chest drain is removed. […] The chest draining tube is placed in 2 cm of water only to seal it; it is not connected to a suction device, which could encourage an anastomotic leak.

• #112 Esophageal Atresia With or Without Tracheoesophageal Fistula Treatment & Management: Approach Considerations, Indications for and Timing of Surgical Intervention, Options for Surgery

  https://emedicine.medscape.com/article/935858-treatment

  Minimally invasive techniques for repair with thoracoscopic surgery are now used in some centers, with good results. […] The management of gastroesophageal reflux (GER) in esophageal atresia is particularly challenging; some advocate aggressive fundoplication, and others prefer more conservative medical treatment. […] Tissue engineering of the esophagus may offer solutions for replacement of lost esophageal tissue. […] The indications for and timing of surgical repair may be determined by using the Waterston, Spitz, or Poenaru prognostic classification system. […] The aforementioned prognostic groupings can allow for the stratification of high-risk patients with esophageal atresia in planning for delayed repair, staged repair, or both; low-risk babies can usually undergo early primary single-stage repair.

• #113 The International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia–tracheoesophageal fistula | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/s41575-023-00789-w

  The project started in October 2019, when, under the auspices of INoEA, a working group consisting of selected members, including both paediatric and adult gastroenterologists, surgeons, respirologists, otolaryngologists, nutritionists, deglutologists, nurses, psychologists and a representative of patients with oesophageal atresia and parent support group in oesophageal atresia, was formed. […] The working group was formed by INoEA members in collaboration with the European Reference Network for Rare Inherited and Congenital (digestive and gastrointestinal) Anomalies and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition to look at formulating evidence-based clinical practice guidelines based on current knowledge for the evaluation and treatment of gastrointestinal, surgical, respiratory, otolaryngological, nutritional, psychological and QOL complications in adolescents and adults with EA-TEF.

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