[Analysis of clinical characteristics and diagnostic value of bronchoscopy in children with congenital esophageal atresia and tracheoesophageal fistula].

Authors

L H Zhang, Z X Zhang, X D Tang, X L Yan, J Ma

Published in

Zhonghua er ke za zhi = Chinese journal of pediatrics. Volume 64. Issue 10. Pages 1173-1178. Sep 15, 2026. Epub Sep 15, 2026.

Abstract

Objective: To analyze the clinical characteristics of children with congenital esophageal atresia and tracheoesophageal fistula (EA-TEF), and compare the diagnostic performance of bronchoscopy (BF) and upper gastrointestinal imaging (UGI). Methods: A retrospective cohort study was conducted on 239 children diagnosed with EA-TEF at Department of Respiratory Intervention of Children's Hospital Affiliated to Shandong University from 2013 to 2025. All patients were classified into type Ⅰ-Ⅴ according to Gross criteria. Perinatal data, initial symptoms and concomitant malformations of each subtype were collected. The positive detection rates of BF and UGI were compared, and the χ² test was adopted for intergroup comparisons. Results: Among the 239 patients, 149 were male and 90 were female. One case (0.4%) belonged to type Ⅰ, 2 cases (0.8%) to type Ⅱ, 191 cases (79.9%) to type Ⅲ (84 cases of type Ⅲa and 107 cases of type Ⅲb), 11 cases (4.6%) to type Ⅳ, and 34 cases (14.2%) to type Ⅴ. The age at diagnosis was 1 (1, 2) days for type Ⅲ patients, 26 (2, 94) days for type Ⅳ patients, and 45 (17, 286) days for type Ⅴ patients. Oral foaming was the main initial symptom of type Ⅲ, occurring in 89 cases (46.6%), while choking was the primary initial symptom of type Ⅴ, occurring in 24 cases (70.6%). A total of 157 cases (65.7%) from all subtypes were complicated with tracheomalacia, among which 142 cases (74.3%) were patients with type Ⅲ EA-TEF complicated with tracheomalacia.Vertebral defects, Anal atresia, Cardiac defects, Tracheoesophageal fistula, Renal anomalies, Limb abnormalities association and laryngeal cleft were each identified in 24 cases (10.0%). The preoperative positive detection rate was 98.6% (136/138) for BF and 92.1% (197/214) for UGI. The combined detection rate was significantly higher than that of UGI alone (98.2% (111/113) vs. 85.0% (96/113), χ²=12.93, P<0.05). For type Ⅳ EA-TEF, the detection rate was 10/11 for BF and 1/8 for UGI; for type Ⅴ EA-TEF, the detection rate was 97.1% (33/34) for BF and 3/12 for UGI. Conclusions: Delayed diagnosis frequently occurs in children with type Ⅳ and type Ⅴ EA-TEF and BF achieves a high detection rate for these two subtypes. Tracheomalacia is a common concomitant malformation of EA-TEF. Bronchoscopy can provide key evidence for preoperative classification and airway assessment of EA-TEF.

PMID:
42742020
Bibliographic data and abstract were imported from PubMed on 15 Sep 2026.

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