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Posterior Tracheopexy during Primary Esophageal Atresia Repair
With Dr. Stephan Derhauf · hosted by Dr. Todd Ponsky
Chapter 1 of 3 · Fundamentals
Introduction
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Esophageal atresia is a foregut anomaly, so usually the trachea is also affected.
At bronchoscopy, you can assess the site of the TE fistula and whether it's more an anterior problem or a posterior problem.
If there is more than 2/3 lumen occlusion, especially from the posterior side, then you should consider doing posterior tracheopexy.
Four patients operated last year all had moderate to severe tracheomalacia at bronchoscopy, especially posterior membranous intrusion of the lumen.
Patients were operated during thoracoscopic esophageal atresia surgery with pexy of the posterior wall towards the spinal ligament, then anastomosis of both ends.
The technique is done with non-absorbable suturing.
All four patients recovered well, and none of them had any respiratory symptoms after surgery.
This technique only takes 6 minutes per suture, and two or three sutures are placed.
Whether routine posterior tracheopexy during primary esophageal atresia repair is right or wrong is uncertain and represents a very hot topic.
Tracheomalacia is so prominent in patients with esophageal atresia that the Utrecht group performs posterior tracheopexy proactively during primary repair instead of requiring a second operation.