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Transillumination of H-type tracheoesophageal fistula using flexible miniature bronchoscopy: an innovative technique for operative localization

  • Anju Goyal
    Affiliations
    Department of Paediatric Surgery, Royal Liverpool Children's Hospital (Alder Hey), The University of Liverpool, Liverpool, England UK
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  • Frank Potter
    Affiliations
    Department of Paediatric Anaesthesia, Royal Liverpool Children's Hospital (Alder Hey), The University of Liverpool, Liverpool, England UK
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  • Paul D. Losty
    Correspondence
    Corresponding author. Institute of Child Health, Royal Liverpool Children's Hospital (Alder Hey), The University of Liverpool, Liverpool, England UK. Tel.: +44 0151 252 5250; fax: +44 0151 228 2024.
    Affiliations
    Department of Paediatric Surgery, Royal Liverpool Children's Hospital (Alder Hey), The University of Liverpool, Liverpool, England UK
    Search for articles by this author

      Abstract

      Precise localization of the fistula is the most important step in the operative strategy for dealing with H-type tracheoesophageal fistula. Bronchoscopic cannulation of the fistula with a Fogarty or ureteric catheter has been recommended to aid ready identification, but it is not always successful. We report an innovative technique that permitted localization of H-type fistula intraoperatively. A flexible pediatric 2.2-mm bronchoscope (Olympus BF Type N20) was steered through a standard endotracheal tube, and the fistula tract was illuminated, making its identification and subsequent repair straightforward. We have successfully deployed this approach in 3 newborns. We recommend the technique to localize H-type fistula.

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