2017 Volume 53 Issue 6 Pages 1144-1148
Purpose: To assess the methods of placing a Fogarty catheter (FC) and the utility of bronchoscopy for observing the surgical procedure in patients undergoing a radical operation for esophageal atresia (EA).
Methods: At our institution, we normally perform a tracheoesophageal fistula (TEF) block using the FC in order to stabilize ventilation when performing an operation for EA. We also carry out observations using a flexible bronchoscope. We retrospectively reviewed the medical records of 20 patients who underwent the operation between 2010 and 2016. We performed examination with a flexible bronchoscope on all the patients. In the case that TEF was located on the head side, we changed the approach to the third intercostal space.
Results: Nineteen of 20 patients (95%) were able to receive the FC insertion. The mean duration from the start of surgery to securing the TEF was 27 minutes, and the mean operating time was 116 minutes. The FC enabled positive pressure ventilation using a respirator. We found 15 patients with relevant clinical records and performed a blind catheter insertion in eight of them. The FC tended to be easier to place in cases of TEF near the tracheal bifurcation.
Conclusions: In a limited surgical field provided by a small incision, TEF block using the FC stabilized ventilation and served as an index of TEF identification. By using the bronchoscope, we were able to confirm the TEF and observe the surgical procedure. Fogarty catheterization was easy to perform and minimally invasive.
