Long-term management of children with tracheo-oesophageal fistula

Abstract

Tracheoesophageal fistula with or without oesophageal atresia (TOF/OA) is a common congenital anomaly of the aero-digestive system. Timely diagnosis of the primary structural defect and later identification of complications are key to ensuring good outcomes. This short article outlines the epidemiology and natural history of TOF and offers practical advice to healthcare professionals to assist them in diagnosis, initial and longer-term management. The structural and functional features of TOF/OA are discussed alongside the associated conditions (including tracheomalacia and gastro-oesophageal reflux) and attendant clinical features. Following surgical correction post-operative and longer-term complications and sequelae are relatively common and include stricture, recurrent respiratory infections, cough, wheeze, dysphagia and gastroesophageal reflux disease. We highlight the importance of taking a multidisciplinary approach to managing children with TOF.