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Congenital H-type tracheoesophageal fistula: Experience from a large Chinese center

Yong Zhao1,2, Zonghan Li1, Shihui Tan1

  • 1Department of Neonatal Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.

Pediatric Research
|May 7, 2026
PubMed

Insights

Congenital H-type tracheoesophageal fistula (H-TEF) diagnosis and treatment were reviewed. Precise localization and nerve monitoring reduced complications, though risk factors require further study.

Area of Science:

  • Pediatric Surgery
  • Congenital Anomalies
  • Gastroenterology

Background:

  • Congenital H-type tracheoesophageal fistula (H-TEF) is a rare anomaly.
  • Understanding its clinical characteristics is crucial for effective management.

Purpose of the Study:

  • To present the clinical characteristics, diagnostic approach, therapeutic management, and outcomes of H-TEF.
  • To identify factors influencing complications in H-TEF patients.

Main Methods:

  • Retrospective review of 51 H-TEF patients (2007-2025).
  • Stratification by major complications (Clavien-Dindo grade ≥ III).
  • Univariate analyses for risk factor identification.

Main Results:

  • Median age at diagnosis was 1 month.
  • Bronchoscopy had 100% detection rate; upper gastrointestinal contrast study (UGI) had 96%.
  • Precise fistula localization prevented anastomotic leakage and recurrence; 41.2% overall complications (29.4% major).

Conclusions:

  • Modifying UGI positioning improves diagnostic yield.
  • Precise localization and nerve monitoring may minimize postoperative complications.
  • Larger studies are needed to identify significant risk factors for complications.
Abstract

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