Recurrent tracheo-oesophageal fistula: experience with 24 patients.

Over an 11 year period, 275 infants with oesophageal atresia and tracheo-oesophageal fistula were treated. Of these, 22 (8%) developed a recurrent fistula. An additional two patients with an established recurrent fistula were referred for secondary surgery. Infants who develop respiratory symptoms associated with feeding following repair of an oesophageal atresia should be investigated urgently with cine-radiography and/or bronchoscopy. Once the diagnosis of a recurrent fistula has been firmly established, operative repair should be undertaken. In our series of 24 patients, there were three deaths (12.5%), four patients developed a second recurrence (16.6%), while a secondary oesphageal replacement was carried out on five patients.