International Journal of Cardiovascular and Thoracic Surgery

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Balloon Dissection for Extra Pleural Approach in Tracheoesophageal Fistula Repair; A Novel Technique

Received: 27 June 2017    Accepted: 04 July 2017    Published: 27 July 2017
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Abstract

Objective: The extra-pleural approach for the tracheoesophageal fistula is preferred by most of pediatric surgeons because the possible substantial anastomotic leak will end in a fistula rather than an empyema. The problem with this technique that it is time consuming for pleural separation and liable for pleural tears. We studied a new method for using of Foley's catheter balloon to push the pleura away from the chest wall in an easier manner and shorter time. Method: A 25 neonate with tracheoesophageal fistula was managed with the extra-pleural approach using the Foley's catheter balloon as a method of pleural separation. Results: The mean time for pleural dissection was 4.5 m (266.4 sec) with a range of 2 m, 47 sec (167 sec) - 6 m, 18 sec (378 sec). Only 4 minor pleural tears were encountered (16%) that passed smoothly. 4 Anastomotic leaks occurred that were managed conservatively and 2 mild Anastomotic strictures (8%) occurred and were managed conservatively. Conclusion: Balloon dissection is a valuable addition to management of esophageal atresia. It accomplishes pleural separation from the rib cage in short time and easy manner with nearly 0% incidence of significant pleural tears. Moreover, it improves the outcome of possible postoperative anastomotic leak without adding to the patient's morbidity or the hospital cost.

DOI 10.11648/j.ijcts.20170303.11
Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 3, Issue 3, May 2017)
Page(s) 14-17
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Tracheoesophageal Fistula, Surgery, Extra-pleural, Foley's Catheter

References
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[4] De Paepe A, Dolk H, Lechat MF, EUROCAT Working Group.(1993)The epidemiology of tracheo-oesophageal fistula and oesophageal atresia in Europe. Arch Dis Child 68:743–748.
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[8] Harmon CM, Coran AG. (2006) Congenital anomalies of the oesophagus. In: Grosfeld JL, O'Neill JA, Fonkalsrud EW, Coran AG, eds. Pediatric Surgery. Philadelphia: Mosby Elsevier Chapt. 67: 1051-1081.
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Author Information
  • Mansoura Children Hospital, Mansoura University, Mansoura, Egypt

  • Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt

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    Basem Saied Abd Elqader, Wagih Mommtaz Ghnnam. (2017). Balloon Dissection for Extra Pleural Approach in Tracheoesophageal Fistula Repair; A Novel Technique. International Journal of Cardiovascular and Thoracic Surgery, 3(3), 14-17. https://doi.org/10.11648/j.ijcts.20170303.11

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    ACS Style

    Basem Saied Abd Elqader; Wagih Mommtaz Ghnnam. Balloon Dissection for Extra Pleural Approach in Tracheoesophageal Fistula Repair; A Novel Technique. Int. J. Cardiovasc. Thorac. Surg. 2017, 3(3), 14-17. doi: 10.11648/j.ijcts.20170303.11

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    AMA Style

    Basem Saied Abd Elqader, Wagih Mommtaz Ghnnam. Balloon Dissection for Extra Pleural Approach in Tracheoesophageal Fistula Repair; A Novel Technique. Int J Cardiovasc Thorac Surg. 2017;3(3):14-17. doi: 10.11648/j.ijcts.20170303.11

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  • @article{10.11648/j.ijcts.20170303.11,
      author = {Basem Saied Abd Elqader and Wagih Mommtaz Ghnnam},
      title = {Balloon Dissection for Extra Pleural Approach in Tracheoesophageal Fistula Repair; A Novel Technique},
      journal = {International Journal of Cardiovascular and Thoracic Surgery},
      volume = {3},
      number = {3},
      pages = {14-17},
      doi = {10.11648/j.ijcts.20170303.11},
      url = {https://doi.org/10.11648/j.ijcts.20170303.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ijcts.20170303.11},
      abstract = {Objective: The extra-pleural approach for the tracheoesophageal fistula is preferred by most of pediatric surgeons because the possible substantial anastomotic leak will end in a fistula rather than an empyema. The problem with this technique that it is time consuming for pleural separation and liable for pleural tears. We studied a new method for using of Foley's catheter balloon to push the pleura away from the chest wall in an easier manner and shorter time. Method: A 25 neonate with tracheoesophageal fistula was managed with the extra-pleural approach using the Foley's catheter balloon as a method of pleural separation. Results: The mean time for pleural dissection was 4.5 m (266.4 sec) with a range of 2 m, 47 sec (167 sec) - 6 m, 18 sec (378 sec). Only 4 minor pleural tears were encountered (16%) that passed smoothly. 4 Anastomotic leaks occurred that were managed conservatively and 2 mild Anastomotic strictures (8%) occurred and were managed conservatively. Conclusion: Balloon dissection is a valuable addition to management of esophageal atresia. It accomplishes pleural separation from the rib cage in short time and easy manner with nearly 0% incidence of significant pleural tears. Moreover, it improves the outcome of possible postoperative anastomotic leak without adding to the patient's morbidity or the hospital cost.},
     year = {2017}
    }
    

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  • TY  - JOUR
    T1  - Balloon Dissection for Extra Pleural Approach in Tracheoesophageal Fistula Repair; A Novel Technique
    AU  - Basem Saied Abd Elqader
    AU  - Wagih Mommtaz Ghnnam
    Y1  - 2017/07/27
    PY  - 2017
    N1  - https://doi.org/10.11648/j.ijcts.20170303.11
    DO  - 10.11648/j.ijcts.20170303.11
    T2  - International Journal of Cardiovascular and Thoracic Surgery
    JF  - International Journal of Cardiovascular and Thoracic Surgery
    JO  - International Journal of Cardiovascular and Thoracic Surgery
    SP  - 14
    EP  - 17
    PB  - Science Publishing Group
    SN  - 2575-4882
    UR  - https://doi.org/10.11648/j.ijcts.20170303.11
    AB  - Objective: The extra-pleural approach for the tracheoesophageal fistula is preferred by most of pediatric surgeons because the possible substantial anastomotic leak will end in a fistula rather than an empyema. The problem with this technique that it is time consuming for pleural separation and liable for pleural tears. We studied a new method for using of Foley's catheter balloon to push the pleura away from the chest wall in an easier manner and shorter time. Method: A 25 neonate with tracheoesophageal fistula was managed with the extra-pleural approach using the Foley's catheter balloon as a method of pleural separation. Results: The mean time for pleural dissection was 4.5 m (266.4 sec) with a range of 2 m, 47 sec (167 sec) - 6 m, 18 sec (378 sec). Only 4 minor pleural tears were encountered (16%) that passed smoothly. 4 Anastomotic leaks occurred that were managed conservatively and 2 mild Anastomotic strictures (8%) occurred and were managed conservatively. Conclusion: Balloon dissection is a valuable addition to management of esophageal atresia. It accomplishes pleural separation from the rib cage in short time and easy manner with nearly 0% incidence of significant pleural tears. Moreover, it improves the outcome of possible postoperative anastomotic leak without adding to the patient's morbidity or the hospital cost.
    VL  - 3
    IS  - 3
    ER  - 

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