MỘT SỐ ĐẶC ĐIỂM LÂM SÀNG VÀ KẾT QUẢ ĐÓNG RÒ KHÍ-THỰC QUẢN BẰNG TRICHLOACETIC ACID 50% TẠI BỆNH VIỆN NHI TRUNG ƯƠNG

Abstract

Tracheoesophageal fistula (TEF) is an abnormal communication between the esophagus and the trachea, causing digestive fluids to enter the airway and leading to respiratory complications. To date, there are various treatment methods for TEF including open thoracic surgery, respiratory endoscopy, digestive endoscopy with tissue sealants (such as histoacryl, fibrin), epithelial regeneration by electrocautery and laser, and trichloroacetic acid (TCA), among which TCA has shown many advantages [1]. The aim of this study was to describe the clinical and bronchoscopic characteristics of patients with TEF and to evaluate the treatment outcomes of TEF using 50% trichloroacetic acid at the National Hospital of Pediatrics. Methods: We conducted a study on 36 patients with TEF from 2017 to May 2025. Results: Among the patients, 25 were male and 11 female, with a male-to-female ratio of 2.27:1. The average age at first fistula closure was 9,2 ± 14,5 months,The number of pneumonia episodes before fistula closure was 3.1 ± 2.1 (min 1, max 10). The average body weight before the first closure was 5.7 ± 3.6 kg. The rate of malnutrition based on age among children with TEF was very high, accounting for 69.4%. The rate of recurrent pneumonia requiring hospital admission was up to 88.9%, and most children had symptoms of aspiration during feeding (94.4%). The most common fistula location was in the lower third of the trachea, accounting for 58.3%. Type C esophageal atresia was the most frequent type, also accounting for 58.3%. The proportion of patients who were successfully treated, with complete resolution of the tracheoesophageal fistula or only a very small residual fistula without any clinical symptoms, was very high at 88.9%.