Perioperative individualized nursing for an adolescent with recurrent tracheoesophageal fistula after endoscopic repair: a case report
4 affiliations
- 1Anesthesiology and Operation Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, Zhejiang, China
- 2Department of Thoracic Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, Zhejiang, China
- 3Department of ENT and Head & Neck Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, Zhejiang, China
- 4Endoscopy Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, Zhejiang, China
Abstract
BackgroundCongenital esophageal atresia (CEA) type III is a common neonatal digestive malformation, and recurrent tracheoesophageal fistula (rTEF) is a refractory long-term postoperative complication. Combined suspension laryngoscopy and flexible bronchoscopy minimally invasive fistula repair is a novel therapeutic strategy, yet standardized perioperative nursing experience targeting adolescents with multiple failed transthoracic surgeries remains scarce. Conventional nursing cannot simultaneously manage compound risks including severe malnutrition, tracheomalacia, adolescent anxiety and airway edema. This case report aimed to summarize multidisciplinary team (MDT) individualized full-cycle nursing protocols for this rare patient population.Case presentationA 17.5-year-old male patient with rTEF, 17.5 years after neonatal primary congenital esophageal atresia repair, with two failed transthoracic fistula closures, presented persistent feeding choking, recurrent pneumonia and severe malnutrition (BMI=15.5 kg/m2). MDT refined airway management, quantitative staged nutrition, whole-course psychological intervention and predictive complication prevention were implemented before and after endoscopic fistula repair. No severe complications occurred during hospitalization. Esophagography and bronchoscopy on postoperative day 10 confirmed complete fistula healing. The patient was discharged on postoperative day 14 with a 0.8 kg weight gain, and one-month follow-up showed sustained fistula repair and continuous weight improvement.ConclusionMDT-driven individualized perioperative nursing effectively reduces airway and nutritional complications and promotes fistula healing in adolescent rTEF patients receiving endoscopic minimally invasive surgery. This case provides replicable evidence-based nursing references for similar complex rare esophageal malformation cases.
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BibTeX
@article{xia2026perioperative,
title = {{Perioperative individualized nursing for an adolescent with recurrent tracheoesophageal fistula after endoscopic repair: a case report}},
author = {Menghua Xia and Zheng Tan and Jia Liu and Lei Wu and Hangyan Zhao and Jie Xia},
journal = {Frontiers in Pediatrics},
year = {2026},
month = oct,
doi = {10.3389/fped.2026.1958428},
url = {https://doi.org/10.3389/fped.2026.1958428},
note = {CC BY},
}
RIS
TY - JOUR
TI - Perioperative individualized nursing for an adolescent with recurrent tracheoesophageal fistula after endoscopic repair: a case report
AU - Menghua Xia
AU - Zheng Tan
AU - Jia Liu
AU - Lei Wu
AU - Hangyan Zhao
AU - Jie Xia
PY - 2026
DA - 2026/10/23
JO - Frontiers in Pediatrics
DO - 10.3389/fped.2026.1958428
UR - https://doi.org/10.3389/fped.2026.1958428
AB - BackgroundCongenital esophageal atresia (CEA) type III is a common neonatal digestive malformation, and recurrent tracheoesophageal fistula (rTEF) is a refractory long-term postoperative complication. Combined suspension laryngoscopy and flexible bronchoscopy minimally invasive fistula repair is a novel therapeutic strategy, yet standardized perioperative nursing experience targeting adolescents with multiple failed transthoracic surgeries remains scarce. Conventional nursing cannot simultaneously manage compound risks including severe malnutrition, tracheomalacia, adolescent anxiety and airway edema. This case report aimed to summarize multidisciplinary team (MDT) individualized full-cycle nursing protocols for this rare patient population.Case presentationA 17.5-year-old male patient with rTEF, 17.5 years after neonatal primary congenital esophageal atresia repair, with two failed transthoracic fistula closures, presented persistent feeding choking, recurrent pneumonia and severe malnutrition (BMI=15.5 kg/m2). MDT refined airway management, quantitative staged nutrition, whole-course psychological intervention and predictive complication prevention were implemented before and after endoscopic fistula repair. No severe complications occurred during hospitalization. Esophagography and bronchoscopy on postoperative day 10 confirmed complete fistula healing. The patient was discharged on postoperative day 14 with a 0.8 kg weight gain, and one-month follow-up showed sustained fistula repair and continuous weight improvement.ConclusionMDT-driven individualized perioperative nursing effectively reduces airway and nutritional complications and promotes fistula healing in adolescent rTEF patients receiving endoscopic minimally invasive surgery. This case provides replicable evidence-based nursing references for similar complex rare esophageal malformation cases.
SN - 2296-2360
ER -