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. 2021 May;21(5):537.
doi: 10.3892/etm.2021.9970. Epub 2021 Mar 23.

Practical safety in the diagnosis and treatment of congenital isolated tracheoesophageal fistula

Radu-Iulian Spataru  1   2 , Dan-Alexandru Iozsa  1   2 , Mircea Ovidiu Denis Lupusoru  3 , Dragos Serban  4   5 , Catalin Cirstoveanu  6   7
Affiliations

Practical safety in the diagnosis and treatment of congenital isolated tracheoesophageal fistula

Radu-Iulian Spataru et al. Exp Ther Med. 2021 May.

Abstract

The rareness of H-type tracheoesophageal fistula in conjunction with its unspecific clinical presentation and wide range of anatomical presentation makes its diagnosis and treatment a problematic topic for both ear, nose and throat (ENT) specialists and pediatric surgeons worldwide. Symptoms and clinical signs of H-TOF are easily misleading. Diagnostic methods, most of the times, are dependent on the physician's experience; therefore, various errors may be made. We analyzed our experience in managing H-TOF cases over the last 15 years. Advice and strategies of action for health professionals directly involved in the diagnosis and treatment were identified, but also errors and mistakes while managing 6 cases. We analyzed 'red flags' but also important steps in the practical safety concerning this rare congenital malformation. Choosing the surgical access for division of the fistula throughout the cervical or thoracic approach is sometimes difficult. A scrupulous perioperative planning is mandatory. A dynamic overview of the patient's presentation never underestimating the subtlety of H-TOF presentation should be conducted for its early recognition and achieving best outcomes.

Keywords: H-type tracheoesophageal fistula; esophageal atresia; gastro-esophageal reflux disease; isolated tracheoesophageal fistula; practical safety.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Esophagogram showing T3 level H-TOF. H-TOF, congenital H-type (isolated) tracheoesophageal fistula.
Figure 2
Figure 2
Bronchoscopic aspect of H-TOF. H-TOF, congenital H-type (isolated) tracheoesophageal fistula.
Figure 3
Figure 3
Intraoperative aspect of H-TOF, thoracic approach. H-TOF, congenital H-type (isolated) tracheoesophageal fistula.
Figure 4
Figure 4
Intraoperative aspect of H-TOF, cervical approach. H-TOF, congenital H-type (isolated) tracheoesophageal fistula.
See this image and copyright information in PMC

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