Preoperative catheterization of H-type tracheoesophageal fistula to facilitate its localization and surgical correction.

PURPOSE: The aim of this study was to demonstrate that preoperative catheterization of H-type tracheoesophageal fistula facilitates its identification and surgical correction.

METHODS

This is a case series of seven patients with H-type tracheoesophageal fistula. Diagnosis was established in three patients and suspected in two more by means of an esophagogram. Confirmation of fistula was performed by endoscopy in all patients. On the day of surgery, either a rigid bronchoscope or a nasolaryngoscope was introduced into the trachea to localize and catheterize the fistula. Because of the location of the fistula, the surgical correction was performed through the neck in five patients and through the thorax in two patients. The fistulas were easily identified surgically and the corrections were successfully performed in all cases. An extensive dissection was not required in any case. Refistulization, identified by bronchoscopic examination one week after surgery, occurred in one patient. Surgical repair was performed again using same procedure described above. All patients are currently asymptomatic and without any evidence of refistulization.

CONCLUSIONS

Preoperative catheterization of H-type tracheoesophageal fistula is useful to facilitate its preoperative identification, to plan the surgical approach, and to decrease operating times and the extent of surgery.