Tracheoesophageal Fistula

This podcast discusses the work up, operative management, and follow-up management of tracheoesophageal fistulas. Dr. Todd Ponsky is an associate professor of surgery and pediatrics and pediatric surgeon at Akron Children's Hospital. Dr. Avraham Schlager is a pediatric surgeon at Akron Children's Hospital. Dr. Daniel von Allmen is the surgeon-in-chief, Lester W. Martin chair of pediatric surgery, senior vice president of the surgical services, and professor at University of Cincinnati department of surgery. Audio Index 00:00:00 Introduction 00:03:27 Diagnosis of TEF 00:06:21 Preoperative planning 00:07:09 Management of TEF with right sided aortic arch 00:09:00 Timing of Repair in stable patient 00:09:56 Management of patient with respiratory compromise prior to OR 00:10:58 Temporizing maneuvers to help improve respiratory function 00:13:26 Management of TEF in patients with duodenal atresia 00:14:29 Role of preoperative bronchoscopy 00:16:20 Positioning of endotracheal tube 00:17:09 Approaches to open technique and benefits of dividing azygous vein 00:17:59 Techniques to divide the tracheoesophageal fistula 00:19:25 Steps to gain exposure 00:20:58 Mobilization of esophagus 00:22:51 Managing an injury to the trachea 00:23:56 Creation of anastomosis 00:24:26 Elongating techniques for long gap esophageal atresia 00:29:06 Approaches to thoracoscopic repair 00:31:42 Techniques and pearls in performing thoracoscopic anastomosis 0034:15 Lung isolation techniques 00:35:46 Postoperative management 00:36:57 Drain management 00:37:44 Managing an anastomotic stricture 00:39:43 Managing an anastomotic leak 00:41:09 Postoperative and long term follow-up 00:42:45 Indications to perform anti-reflux surgery 00:43:46 Management of pure esophageal atresia 00:44:38 Closing remarks Intro and outro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: http://creativecommons.org/licenses/by/3.0/