Posterior tracheopexy may effectively repair tracheo-esophag
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According to a recent research report, the surgical treatment of recurrent tracheo-esophageal fistula (TEFs) that incorporates a posterior tracheopexy and rotational esophagoplasty is highly effective for preventing re-recurrence with low perioperative morbidity.

Researchers aimed to review their experience with the treatment of recurrent TEF using posterior tracheopexy, focusing on operative risks and long-term outcomes.

Researchers conducted a retrospective review of patients with esophageal atresia TEF with recurrent TEF treated at 2 institutions. They approach recurrent TEFs surgically. Once the TEF is divided and repaired, the membranous trachea is sutured to the anterior longitudinal ligament of the spine (posterior tracheopexy) and the esophagus is rotated into the right chest (rotational esophagoplasty), separating the suture lines widely. To detect re-recurrence, patients undergo endoscopic surveillance during follow-up.

Sixty-two patients with a recurrent TEF were surgically treated at a median age of 14 months. All had significant respiratory symptoms. On referral, 24 had earlier failed endoscopic and/or surgical attempts at repair. Twenty-nine required a concomitant esophageal anastomotic stricturoplasty or stricture resection. Postoperative morbidity included 3 esophageal leaks and 1 transient vocal cord dysfunction. They have identified no recurrences, with a median follow-up of 2.5 years, and all symptoms have resolved.

In conclusion, the surgical treatment of recurrent TEFs that incorporates a posterior tracheopexy and rotational esophagoplasty is highly effective for preventing re-recurrence with low perioperative morbidity.

Journal of the American College of Surgeons
Source: https://doi.org/10.1016/j.jamcollsurg.2021.01.011
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