The early diagnosis and management of isolated tracheoesophageal fistula

Objective To present the methods of early diagnosis and management of isolated tracheoesophageal fistula(ITEF).Methods The medical records of 12 babies with ITEF were analyzed retrospectively.The fistula was noted by contrast esophagography and/or bronchoscopy.The fistula located at C7 on 2 cases,at C7-T1 on 2,at T1 on 1,at T1-T2 on 2,at T2-T3 on 3,and at T3 on 1.The fistula was repaired through cervical approach on 10 cases and the other 2 through extrapleural approach.Results Ten babies recovered uneventfully.One who underwent fistula repair through extrapleural approach had anastomotic leak and was cured by conservative treatment.One older baby died of severe pulmonary infection and respiratory failure.Conclusions ITEF is a rare congenital anomaly with chromic morbidities.The diagnosis of ITEF should be suspected if baby chokes on attempting to feed and has cyanotic spells in the first day of life,and the diagnosis can be confirmed by contrast esophagography and bronchoscopy.A timely repair of ITEF can be performed through cervical approach successfully in overwhelming majority babies. Key words: Tracheoesophageal fistula;  Bronchoscopes;  Esophageal atresia