Related Experiment Video

Updated: Nov 18, 2025

Vessel-sparing Excision and Primary Anastomosis
08:09

Vessel-sparing Excision and Primary Anastomosis

Published on: January 7, 2019

11.8K

Effect of Posterior Tracheopexy on Risk of Recurrence in Children after Recurrent Tracheo-Esophageal Fistula Repair

Ali Kamran1, Benjamin Zendejas1, Jay Meisner1

  • 1Departments of General Surgery, Boston Children's Hospital, Boston, MA.

Journal of the American College of Surgeons
|February 8, 2021
PubMed

Insights

Recurrent tracheo-esophageal fistula (TEF) in children can be effectively treated with posterior tracheopexy and rotational esophagoplasty. This surgical approach significantly reduces re-recurrence rates and improves patient outcomes.

Area of Science:

  • Pediatric Surgery
  • Thoracic Surgery
  • Gastroenterology

Background:

  • Recurrent tracheo-esophageal fistula (TEF) is a challenging complication following initial repair of esophageal atresia and TEF.
  • Existing therapeutic options have variable success rates and high re-recurrence rates, hindering optimal treatment selection.
  • Limited data from small cohorts and short follow-up periods complicate the assessment of treatment efficacy.

Purpose of the Study:

  • To evaluate the effectiveness of posterior tracheopexy combined with rotational esophagoplasty for treating recurrent TEF.
  • To assess the operative risks and long-term outcomes associated with this surgical technique.
  • To determine the re-recurrence rate after surgical management of recurrent TEF.

Main Methods:

  • A retrospective review of 62 patients with recurrent TEF treated between 2011 and 2020 at two institutions.
  • Surgical intervention involved dividing the TEF, performing posterior tracheopexy (suturing trachea to spine), and rotational esophagoplasty.
  • Endoscopic surveillance was used to monitor for re-recurrence during follow-up.

Main Results:

  • Sixty-two patients underwent surgical treatment for recurrent TEF at a median age of 14 months, with all presenting significant respiratory symptoms.
  • Twenty-four patients had prior failed endoscopic or surgical repairs; 29 required concomitant esophageal stricture management.
  • No recurrences were observed during a median follow-up of 2.5 years, with complete resolution of symptoms and low perioperative morbidity (3 esophageal leaks, 1 vocal cord dysfunction).

Conclusions:

  • Posterior tracheopexy and rotational esophagoplasty represent a highly effective surgical strategy for recurrent TEF.
  • This combined surgical approach significantly prevents re-recurrence of TEF.
  • The procedure is associated with low perioperative morbidity, offering a favorable long-term outcome for affected children.
Abstract

More Related Videos

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function09:40

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function

Published on: April 17, 2020

14.4K
Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation07:28

Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation

Published on: October 11, 2024

540

Related Concept Videos

Pneumothorax-II01:27

Pneumothorax-II

Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
601
Tracheostomy: Procedure and Tubes01:28

Tracheostomy: Procedure and Tubes

A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
1.9K
Trachea01:22

Trachea

The trachea, commonly known as the windpipe, is a vital part of the human respiratory system. It serves as a passageway for air to travel between the larynx and the bronchi, allowing oxygen to reach the lungs. Let's explore its anatomical features, dimensions, layers of the tracheal wall, associated muscles, and the functions of its parts.
Anatomical Features:
Location: About half of the trachea is situated in the neck, anterior to the esophagus, and extends from the larynx (at the level of...
3.6K
Tracheostomy Decannulation01:21

Tracheostomy Decannulation

Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
605
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
258
Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
245