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Endoscopic treatment of tracheoesophageal fistula

Surgical treatment (ST) is the classical method of treatment of both congenital and recurrent tracheoesophageal fistula (RTEF). On the other hand, endoscopic treatment (ET) of RTEF has been reported with an increased frequency in the literature. This method of treatment consists of either deepithelialization of the tract of the fistula or glue application to the fistula, almost always from the tracheal side and using a ventilating rigid bronchoscope. For these procedures different equipments and materials are used in the literature and they are performed either alone or in combination. Even though ET of RTEF was reported frequently in the last two decades, a standard method of this option has not been constituted yet. Although ET is reported to be used for all types of tracheoesophageal fistula in different reports, its use is rather accepted in cases with RTEF. ET is an easy, less expensive and less invasive method and has low complication rates when compared to ST. It can be repeated easily and does not have any adverse effect for any necessary ST in this area. Main disadvantages of this method are its high recurrence rate and prolonged period of aspiration because of recurrences and repeated attempts of endoscopic closure. In conclusion, ET is a promising alternative method for the management of RTEF, with an increased popularity. Thus, it can be performed as the first line therapy of the RTEF. Patients with failed endoscopic management should be managed surgically immediately.