2003 Volume 39 Issue 1 Pages 64-70
Purpose Respiratory management of C-type esophageal atresia sometimes becomes difficult due to air leakage through the tracheoesophageal fistula (TEF). Pediatnc pneumonectomy can also become complicated due to the lack of a device small enough for diverted ventilation. To address these issues, we occluded the TEF or lobar bronchus with a Fogarty catheter through a bronchoscope. These cases were reviewed. Methods/Results We treated five patients with C-type esophageal atresia and eight with cystic lung disease [Tracheoesophageal fistula] Prior to surgery, a Fogarty catheter was inserted into the lower esophagus through the TEF under bronchoscopic observation, and a balloon was inflated. Thereafter, only the bronchoscope was withdrawn, and endotracheal intubation was performed. The Fogarty catheter was removed when the TEF was secured during the surgery. For this bronchoscopic procedure, 56 mm was used on average. With this occlusion, air leakage through the TEF during surgery was completely controlled. [Lobectomy] A Fogarty catheter was placed in the pathologic lobar bronchus The balloon was inflated to prevent purulent sputum from spilling into the normal lobe and prevent the over expansion of cysts. For this bronchoscopic procedure, 75 mm was used on average. With this occlusion expansion of the cystic lesion in the lungs was completely controlled during surgery. Conclusions Occlusion of the TEF or the bronchus using a Fogarty catheter through the trachea is a simple and safe procedure that can maintain stable ventilation during surgical treatment for these diseases.
