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KMID : 0605920110170020154
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Journal of Korean Association of Pediatric Surgeons
2011 Volume.17 No. 2 p.154 ~ p.161
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Clinical Experience of H-type Tracheoesophageal Fstula
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Cho Hwui-Dong
Nam So-Hyun
Cho Min-Jeng
Kim Tae-Hoon
Kim Dae-Yeon
Kim Seong-Chul
Kim In-Koo
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Abstract
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Tracheoesophageal fistula without esophageal atresia (H-type TEF) is a congenital anomaly that is characterized by a fistula between the posterior wall of the trachea and the anterior wall of the esophagus, not accompanied by esophageal atresia. The purpose of this study is to investigate the clinical characteristics, diagnostic time, the side of cervical approach and short term result after surgery by searching medical records of patients treated for H-type TEF. The search was done at University of Ulsan, Department of Pediatric Surgery of Asan Medical Center, and the total number of patients from May 1989 to December 2010 was 9 with M:F ratio of 1:2. The median gestational age was () wks. Seven out of nine patients were born at term and the other two were born premature. The clinical presentation was aspiration pneumonia, difficulty in feeding, chronic cough, vomiting, abdominal distension and growth retardation. The symptoms presented right after birth. The diagnosis was made with esophagography and the median time of diagnosis was 52 days of life. The majority of surgical corrections were performed within two weeks of diagnosis (median; 15d, range; 1d - 6m). Six patients had associated anomalies, and cardiac anomalies were most common. The cervical approach was utilized in all cases (right 2, left 7). Transient vocal cord palsy and minor esophageal leakage complicated two cases. Although the diagnosis of H-type TEF was difficult and often delayed, we had a good short term result. The left cervical approach was preferred
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KEYWORD
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H-type fistula, Esophageal atresia, Tracheoesophageal fistula, Cervical incision
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