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Endoscopic management of recurrent tracheoesophageal fistula with trichloroacetic acid chemocauterization: a preliminary report

Manuel Lopez¹, Jean Michel Prades² & Francois Varlet¹ ¹Department of Pediatric Surgery, and ²Otorhinolaryngology University Hospital of Saint Etienne, France
Manuel Lopez, Jean Michel Prades, Francois Varlet
Department of Pediatric Surgery, Saint Etienne, France

 

Abstract 

Objective: Open repair with a second thoracotomy is technically challenging and has a high risk of complications for the treatment of a recurrent tracheoesophageal fistula (RTEF). Therefore, less invasive endoscopic techniques have been developed. We report our initial experience with trichloroacetic acid chemocauterization for recurrent trachea-esophageal fistula by endoscopy. 

Methods: Two patients who had an open repair with thoracotomy for congenital tracheoesophageal fistula and were diagnosed with large RTEF. Rigid ventilating bronchoscopy with telescopic magnification was used to evaluate and manage the RTEF. After identification of the fistula opening, a 50% TCA-soaked small cotton ball was applied in the opening 3 times during each session, in day surgery.
Results: The mean number of procedures was 2, and the fistulae were closed in both cases. Closure of the fistula was confirmed by esophagogram and/or bronchoscopy. There were no postoperative complications.
Conclusion: The results of this initial experience showed that chemocauterization with TCA can be safe and effective for the management of RTEF.