Surgical treatment of recurrent tracheo-esophageal fistula using a latissimus dorsi pedicled muscle flap —Report of a case— |
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Authors: | Hiromasa Fujita MD Hideyuki Kawahara Hiroshi Yoshimatsu Kashio Nakamura |
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Institution: | (1) The Department of Thoracic and Cardiovascular Surgery, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Fukuoka, Japan;(2) The Department of Pediatrics, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Fukuoka, Japan;(3) First Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830 Fukuoka, Japan |
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Abstract: | We report herein, a case of a child in whom a prepared latissimus dorsi muscle flap was successfully utilized in the treatment
of recurrent tracheo-esophageal fistula (TEF). A 12-month-old girl who had undergone a primary repair of Gross’s type C esophageal
atresia at 6 days of age and a secondary repair of recurrent TEF at 4 months of age experienced, postoperatively, repeated
episodes of aspiration pneumonia caused by recurrence of the fistula. Thus, we performed a reoperation in which the fistula
was excised, and a latissimus dorsi muscle pedicled flap was interposed between the tracheal and esophageal suture lines.
Viability of the muscle flap was adequately achieved by means of a three-stage delayed operation. Although a minor anastomotic
leakage of the esophagus was found postoperatively, it healed spontaneously, and the patient was commenced on a normal diet
orally without any problems at 26 months of age. |
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Keywords: | recurrent tracheo-esophageal fistula congenital esophageal atresia latissimus dorsi muscle flap |
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