{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T02:15:09Z","timestamp":1790475309802,"version":"4.1.0"},"reference-count":29,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T00:00:00Z","timestamp":1712016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Congenital h-type tracheoesophageal fistula (H-TEF) without esophageal atresia (EA) represents about 4% of congenital esophageal anomalies. The diagnosis is challenging, and surgery is considered curative. The aim was to report a national survey on the diagnosis, management, and outcome of patients with congenital H-TEF. Methods: Following approval of the Italian Society of Pediatric Surgery, a survey was sent to all Pediatric Surgery Units to retrospectively collect H-TEF treated in the period 2010\u20132022. Descriptive analysis was performed, and results are given as prevalence, mean \u00b1 standard deviation (SD), or median and interquartile range (IQR). Results: The survey was sent to 65 units. Seventeen responded with one or more cases; 78 patients were diagnosed with H-TEF during the study period. Associated malformations were present in 43%, mostly cardiac (31%). The most frequent symptoms were cough (36%), bronchopneumonia (24%), and dysphagia (19%). H-TEF was detected by tracheobronchoscopy (90%), and\/or upper GI (58%), and\/or esophagoscopy (32%). The median age at diagnosis was 23 days (1 day\u201318 years). The most common approach was cervicotomy (76%), followed by thoracoscopy (14%) and thoracotomy (9%). The fistula underwent ligation and section of the fistula in 90% of the patients and clip closure and section in 9%. In one patient, the fistula was cauterized endoscopically. H-TEF preoperative cannulation was performed in 68% of cases, and a drain was placed in 26%. One month after surgery, 13% of the patients had mild persisting symptoms, mainly hypophonia. Recurrence occurred in 5%, and a second recurrence occurred in 1%. Conclusions: H-TEF prevalence was six cases\/year, consistent with the expected rate of five cases\/year in our country. The diagnosis was challenging, sometimes delayed, and, in most patients, required multiple examinations. Fistula ligation and section through cervicotomy were the most frequent treatment. Long-term outcomes are good, and recurrence is a rare event.<\/jats:p>","DOI":"10.3390\/children11040423","type":"journal-article","created":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T10:58:31Z","timestamp":1712055511000},"page":"423","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Diagnosis and Management of Congenital H-Type Tracheoesophageal Fistula: Results of a National Survey"],"prefix":"10.3390","volume":"11","author":[{"given":"Cecilia","family":"Morchio","sequence":"first","affiliation":[{"name":"School of Pediatric Surgery, University of Florence, 50100 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba","family":"Ganarin","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Ca\u2019 Foncello Hospital, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Conforti","sequence":"additional","affiliation":[{"name":"Neonatal Surgery Unit, Medical and Surgical Department of Fetus-Newborn-Infant, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00100 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Leva","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Fondazione IRCCS Ca\u2019 Granda\u2014Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Gaglione","sequence":"additional","affiliation":[{"name":"UOC Pediatric Surgery Unit, AORN Santobono-Pausilipon, 80100 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaia","family":"Brenco","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, IRCCS Giannina Gaslini\u2019s Hospital, 16100 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9610-1708","authenticated-orcid":false,"given":"Elisa","family":"Zambaiti","sequence":"additional","affiliation":[{"name":"Department of Pediatric General Surgery, Regina Margherita Children\u2019s Hospital, Azienda Ospedaliero Universitaria Citt\u00e0 della Salute e della Scienza, 10100 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore Fabio","family":"Chiarenza","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, San Bortolo Hospital, 36100 Vicenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Caldaro","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy and Surgery Unit, Bambino Gesu Children\u2019s Hospital, IRCCS, 00100 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Cheli","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Ospedale Papa Giovanni XXIII, 24100 Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3341-5379","authenticated-orcid":false,"given":"Giovanni","family":"Boroni","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, ASST Spedali Civili di Brescia, 25100 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6864-0709","authenticated-orcid":false,"given":"Elena Sofia","family":"Marcandella","sequence":"additional","affiliation":[{"name":"Paediatric Surgery Unit, Women\u2019s and Children\u2019s Health Department, University of Padua, 35100 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Riccipetitoni","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, \u201cV. Buzzi\u201d Children\u2019s Hospital, 20100 Milan, Italy"},{"name":"Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastiano","family":"Cacciaguerra","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Ospedale Garibaldi-Nesima, 95100 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Di Benedetto","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, G. Rodolico\u2014San Marco Hospital, 95100 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Gentilino","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Woman and Child Department, \u201cFilippo Del Ponte\u201d Hospital, ASST Sette Laghi, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7590-9505","authenticated-orcid":false,"given":"Gabriele","family":"Lisi","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Santo Spirito Hospital, University of Chieti-Pescara, 65100 Pescara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Morini","sequence":"additional","affiliation":[{"name":"Department of Maternal and Child Health and Urological Sciences, La Sapienza University, 00100 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Midrio","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Ca\u2019 Foncello Hospital, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,2]]},"reference":[{"key":"ref_1","unstructured":"Gross, R.E. 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Open"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/4\/423\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:22:28Z","timestamp":1760106148000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/4\/423"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,2]]},"references-count":29,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["children11040423"],"URL":"https:\/\/doi.org\/10.3390\/children11040423","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,2]]}}}