PMID- 9553183
OWN - NLM
STAT- MEDLINE
DCOM- 19980610
LR  - 20131121
IS  - 0179-0358 (Print)
IS  - 0179-0358 (Linking)
VI  - 13
IP  - 4
DP  - 1998 Apr
TI  - Endoscopic treatment of recurrent tracheo-oesophageal fistulae: long-term 
      results.
PG  - 256-8
AB  - Recurrent tracheo-oesophageal fistula (RTOF) occurs in 5%-15% of patients 
      following oesophageal atresia repair. Re-thoracotomy is technically challenging 
      and associated with significant morbidity, including a re-fistulation rate of 
      10%-22%. Endoscopic occlusion of the RTOF with tissue adhesives (fibrin glue, 
      Histoacryl) is reported to be safe and highly effective. However, long-term 
      results of such therapy are absent from the literature. A postal survey of 13 
      institutions reporting the use of such treatment regimes for RTOF in the 
      literature between 1974 and 1995 was performed, and data collected concerning the 
      long-term outcomes of their reported patients. Eleven institutions responded to 
      the request for data, providing 22 patients (age range 1 month to 12 years) for 
      review. All had undergone initially successful RTOF closure by endoscopic methods 
      and had been followed up for a median of 107 months (range 3-264 months). There 
      was no morbidity or mortality directly related to the procedure. Overall, only 
      55% of these endoscopically treated fistulas remained closed long-term. Fistula 
      recurrence invariably occurred within 12 months of successful therapy (median 46 
      days, range 9-335). Most patients required multiple endoscopic procedures to 
      achieve successful RTOF closure (median 2.0, range 1-4 attempts), although 
      significantly fewer attempts were required with fibrin glue therapy. Surgical 
      re-exploration remains the treatment of choice in the fit child. Endoscopic 
      therapy offers a safe and elegant alternative to high-risk surgery in the sick 
      child, although repeated treatments may be required for successful RTOF closure.
FAU - Willetts, I E
AU  - Willetts IE
AD  - Paediatric Surgical Directorate, John Radcliffe Hospital, Headington, Oxford, UK.
FAU - Dudley, N E
AU  - Dudley NE
FAU - Tam, P K
AU  - Tam PK
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Pediatr Surg Int
JT  - Pediatric surgery international
JID - 8609169
RN  - 0 (Fibrin Tissue Adhesive)
RN  - 0 (Tissue Adhesives)
RN  - F8CEP82QNP (Enbucrilate)
SB  - IM
MH  - Child
MH  - Child, Preschool
MH  - Enbucrilate/therapeutic use
MH  - Endoscopy
MH  - Fibrin Tissue Adhesive/therapeutic use
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Recurrence
MH  - Tissue Adhesives/*therapeutic use
MH  - Tracheoesophageal Fistula/*congenital/*therapy
MH  - Treatment Outcome
EDAT- 1998/06/13 00:00
MHDA- 1998/06/13 00:01
CRDT- 1998/06/13 00:00
PHST- 1998/06/13 00:00 [pubmed]
PHST- 1998/06/13 00:01 [medline]
PHST- 1998/06/13 00:00 [entrez]
AID - 10.1007/s003830050310 [doi]
PST - ppublish
SO  - Pediatr Surg Int. 1998 Apr;13(4):256-8. doi: 10.1007/s003830050310.