Intercostal pedicled flap in esophageal atresia.

Since 1974 we have used an intercostal pedicled flap (IPF) between the esophageal anastomosis and the sutured trachea in a single case of recurrent tracheoesophageal fistula (TEF) and in four cases of primary repair of esophageal atresia (EA) and TEF in which the distance between both ends was greater than 2.5 cm and with a certain degree of tension in the anastomotic line. Furthermore, in the last two cases reported in this article, we have been able to use the IFP in an extrapleural approach in a way not previously reported. The short-term and long-term follow-ups have been excellent without any complications relating to the esophagus itself or to the pedicle flap of intercostal muscle. The method is considered particularly useful in recurrent fistulas.