Parolini F, Boroni G, Stefini S, Agapiti C, Bazzana T, Alberti D. Role of preoperative tracheobronchoscopy in newborns with esophageal atresia: A review. World J Gastrointest Endosc 2014; 6(10): 482-487 [PMID: 25324919 DOI: 10.4253/wjge.v6.i10.482]
Corresponding Author of This Article
Filippo Parolini, MD, Department of Paediatric Surgery, Azienda Ospedaliera Spedali Civili, Piazzale Spedali Civili 1, 25123 Brescia, Italy. parfil@hotmail.it
Research Domain of This Article
Surgery
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Filippo Parolini, Giovanni Boroni, Daniele Alberti, Department of Pediatric Surgery, Azienda Ospedaliera Spedali Civili, 25123 Brescia, Italy
Stefania Stefini, Tullia Bazzana, Department of Pediatric Othorinolaryngology, Azienda Ospedaliera Spedali Civili, 25123 Brescia, Italy
Cristina Agapiti, Department of Pediatric Anesthesiology and Intensive Care Unit, Azienda Ospedaliera Spedali Civili, 25123 Brescia, Italy
Daniele Alberti, University of Brescia, 25123 Brescia, Italy
Author contributions: Parolini F conceptualized and designed the study, designed the data collection instruments, drafted the initial manuscript, reviewed and revised the manuscript and approved the final manuscript as submitted; Boroni G designed the data collection instruments, drafted, reviewed and revised the manuscript and approved the final manuscript as submitted; Stefini S designed the data collection instruments, drafted, reviewed and revised the manuscript and approved the final manuscript as submitted; Agapiti C designed the data collection instruments, drafted, reviewed and revised the manuscript and approved the final manuscript as submitted; Bazzana T coordinated and supervised data collection, critically reviewed the manuscript and approved the final manuscript as submitted; Alberti D conceptualized and designed the study, critically reviewed the manuscript and approved the final manuscript as submitted.
Correspondence to: Filippo Parolini, MD, Department of Paediatric Surgery, Azienda Ospedaliera Spedali Civili, Piazzale Spedali Civili 1, 25123 Brescia, Italy. parfil@hotmail.it
Telephone: +39-03-03996201 Fax: +39-03-03996154
Received: April 30, 2014 Revised: August 19, 2014 Accepted: September 6, 2014 Published online: October 16, 2014
Abstract
Preoperative tracheobronchoscopy (TBS) in the diagnostic assessment of newborns affected by esophageal atresia (EA) was described in 1981. Nevertheless, the value of the procedure is actually much debated; only a few studies have clearly explored the advantages of TBS and this procedure is not yet routinely included in the diagnostic and therapeutic assessment in many international pediatric surgery settings. Routine preoperative TBS is a safe procedure that enables the accurate examination of the tracheobronchial tree, the visualization of tracheoesophageal fistula and the diagnosis of tracheomalacia or associated respiratory anomalies. When a distal fistula is found, its occlusion with a Fogarty balloon catheter improves mechanical ventilation and facilitates surgical repair. This review provides a detailed overview on the use of TBS in newborns with EA, focusing on technical aspects, anesthesiological management, indications and limits. The benefits and risks of the procedure are also compared with alternative diagnostic tools, such as an esophageal contrast study, computed tomography scan and ultrasound.
Core tip: Despite preliminary tracheobronchoscopy (TBS) in the management of newborns affected by esophageal atresia (EA) being described in 1981, only a few studies have clearly explored the advantages of TBS in the subsequent years and this procedure is still not routinely part of the diagnostic and surgical assessment in many international pediatric surgery centers. This review provides a detailed overview on the use of TBS in newborns with EA, focusing on technical and anesthesiological aspects, benefits and risks of this procedure. TBS is also compared with alternative diagnostic tools, such as an esophageal contrast study, computed tomography scan and ultrasound.
