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Video

Laryngology/Broncho-Esophagology

(A707) Case Series – Minimally Invasive Endoscopic Repair of Tracheoesophageal Fistula using Chemocauterization with Trichloroacetic Acid

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Peter Kwak, MD

    Resident Physician PGY4
    Department of Otolaryngology - Head and Neck Surgery, Virginia Commonwealth University
    Richmond, Virginia, United States

    • Co-Author(s)

  • DS

    Daniel Scheese, MD

    Surgical Resident
    Department of Surgery, Virginia Commonwealth University
    HENRICO, Virginia, United States

  • JS

    Jason P. Sulkowski, MD

    Department of Surgery, Virginia Commonwealth University, Division of Pediatric Surgery, Children’s Hospital of Richmond at VCU, United States

  • PL

    Patricia Lange, MD

    Professor of Surgery and Pediatrics
    Department of Surgery, Virginia Commonwealth University, Division of Pediatric Surgery, Children’s Hospital of Richmond at VCU
    Richmond, Virginia, United States

    • Senior Author(s)

  • Rajanya S. Petersson, MD

    Professor
    Children’s Hospital of Richmond at VCU
    Richmond, Virginia, United States

Disclosure(s):
Peter Kwak, MD: No relevant relationships to disclose.
Daniel Scheese, MD: No relevant relationships to disclose.
Patricia Lange, MD: No relevant relationships to disclose.
Rajanya S. Petersson, MD: No relevant relationships to disclose.


Introduction: This case series describes our experience using 50% trichloroacetic acid (TCA) for the management of tracheoesophageal fistula (TEF).

Methods: The authors conducted a retrospective chart review of patients with tracheoesophageal fistula (TEF) who underwent endoscopic chemocauterization with 50% TCA between 2023-2024 at a tertiary care medical center.

Results: Two of two (100%) patients with TEF were successfully repaired endoscopically with topical 50% TCA application, each requiring three treatments at approximately one-month intervals. The efficacy was well demonstrated by subsequent bronchoscopy at 6-month follow up. There were no significant complications from the endoscopic treatment.

Conclusions: Here we present our experience with a minimally invasive endoscopic approach for management of TEF using chemocauterization with 50% TCA. This technique is a safe alternative to an open surgical ligation which is associated with significant risk of morbidity. Though this is a described treatment option in other parts of the world, to our knowledge, this treatment method has not been reported in the American literature. We would like to build evidence for its use as a safe and effective treatment method in the United States.