Abstract

Tracheoesophageal (TE) malformations represent a real challenge to all paediatric surgeons and paediatric intensivists even in advanced paediatric surgical facilities. These anomalies include a wide spectrum of anatomical alterations resulting in respiratory difficulties and feeding impairment most commonly in the first few hours after birth. The third most common configuration of which is diagnosed when an isolated TE fistula happened without any esophageal discontinuity, this is called H-type, Vogt IV, and Gross E. Usual clinical presentation is recurrent aspirations, choking, and cyanosis after feeding. A high index of suspicion accompanied by an experienced radiologist, and rigid bronchoscopy could usually lead to the diagnosis. The classical surgical approach is usually via the right cervical route rather than thoracotomy, and more recently, the thoracoscopic repair. In this report, we describe a successful repair of an isolated TE fistula in a 11-month-old male infant presented with history of frequent chocking upon feeding and recurrent pneumonia. Five days of nasogastric feeding and stabilization were enough to make this patient fit for right thoracoscopy under general anaesthesia. Hem-o-lok polymer clips were applied on each side of the fistula, then the fistula was divided with scissors. Smooth postoperative period at our paediatric ICU, and the patient was sent home with full feeding on the 6th postoperative day. Then follow up visits were scheduled to see the patient within 10 days, one month, two months, four months, and one year and two years, he was completely free from any respiratory complaints, and he is thriving well. In conclusion, despite being infrequent, isolated TE fistula represents a real diagnostic and therapeutic challenge in paediatric surgery. Thoracoscopic repair becomes increasingly used in many centres globally with obvious safety. Hem-o-lok polymer clips can be a safe option to seal both ends of TE fistula before its division thoracoscopically

Cite as: Alhasani AA. Successful Thoracoscopic Repair of Isolated Tracheoesophageal Fistula Using Hem-o-lok Polymer clips: A case report. Coc Cer Derg/Turkish J Ped Surg 2022;36(1): 66-69. doi: 10.29228/JTAPS. 53679