[Postoperative recurrence of esophago-tracheal fistula. Significance of peroperative catheterization of the fistula with tracheoscopy. Apropos of 10 cases].

Abstract

Ten children with recurrent tracheo-oesophageal fistula have been treated over 13 years (1976-1988). Five patients were referred from other centers. The original pathology was oesophageal atresia in eight and two patients had a tracheo-oesophageal fistula alone. Barium swallow demonstrated the recurrent fistula in only five of eight cases. In fact, the key examination is tracheoscopy providing that catheterisation of the fistula. The position of the catheter is verified radiologically. The difficulties of surgery in recurrent fistula are linked to the problem of locating the level of the fistula peroperatively. Without catheterisation of the fistula, there were one failure out of three cases (one dead). By contrast, in the seven cases where the fistula was catheterised, a successful outcome was always obtained. The failure of surgery for recurrent tracheo-oesophageal fistula is not linked to a technical problem of closure of the fistulous tract but to failure to localize the fistula adequately.