Thoracoscopic Management of Complex Esophageal Atresia Cases: Esophagobronchial Fistula and Recalcitrant Stricture

Abstract

Abstract Introduction: Tracheoesophageal fistula (TEF) is a common congenital anomaly of the respiratory tract that is seen in ~1 in 3500 live births. Typically, TEF occurs with esophageal atresia (EA) and may be associated with other congenital heart or genitourinary anomalies as part of the VACTERL or CHARGE syndromes.1 Common complications after EA and TEF repair include esophageal stricture (35%), anastomotic leak (16%), and recurrent fistula (3%).2 Most strictures respond to dilatation attempts or conservative management with antireflux medication,3 but recalcitrant strictures may require resection and reanastomosis. Another lesser seen complication is an esophageal–bronchial fistula (EBF), which is a new fistula that forms when a leak from the anastomosis causes the site to become adherent to the lung parenchyma and a new communication forms with the peripheral bronchioles.4 Materials and Methods: EBF: This patient is a 2-year-old with history of TEF repair at birth who presented with recurrent pneu...