A case of successful treatment of an isolated tracheoesopha- geal fistula in a 2-month-old child

Abstract

Isolated tracheoesophageal fistula is a very rare malformation, which is a pathological communication between the walls of the esophagus and the trachea. The entry of food into the trachea causes severe obstructive and ventilatory disorders in infants. Surgical treatment of developmental anomalies includes open thoracic or transsternal access, which is traumatic, often complicated by pleurisy and mediastinitis in the postoperative period and long-term musculoskeletal deformities. Purpose. To demonstrate the effectiveness of minimally invasive surgery in the correction of this defect. Fibro-tracheo-bronchoscopy confirmed an isolated tracheoesophageal fistula in a 2-month-old child. Thoracoscopic intervention using 3 ports was chosen and performed as a surgical method of treatment. A large tracheoesophageal fistula, up to 10 mm, was found. The tracheal end of the fistula was sutured with 2 ligatures, tied and cut off. The defect in the wall of the esophagus was hermetically sutured. The postoperative period proceeded without complications. Enteral nutrition through the nipple started on the 10th day. Control examination after 1 and 6 months: the child has no anxiety; psychomotor development corresponds to age, on esophagoscopy the esophagus is freely passable, constrictions and defects were revealed . Conclusion. The high resolution and ergonomics of modern endoscopic equipment made it possible to visualize the malformation in an infant in detail, to separate pathological communication with minimal trauma and to avoid early and long-term complications.