| Summary: | Background: Esophageal atresia (EA) is the most common congenital anomaly affecting the esophagus, and recurrent tracheoesophageal fistula (rTEF) is one of its most serious complications, usually occurring after primary surgical closure in 3–14 % of patients. Endoscopic management involving the topical application of 50 % trichloroacetic acid (TCA) and clipping systems has favorable results and a low incidence of complications. However, it has been reported that multiple applications are necessary to achieve adequate closure. Methods: This therapeutic study describes a preliminary 5-step double endoscopic approach involving topical application of 50 % TCA and clips such as the OTS/OVESCO System. Results: The rTEF was completely closed in three patients (n = 3); in 2/3 of patients, the OTS/OVESCO system was used. Postoperative esophagogram confirmed the obliteration of the defect, and no patient presented with complications during the 3-year follow-up, with complete resolution of respiratory symptoms. Conclusions: This preliminary study suggests that the 5-step dual endoscopic approach for closure of the rTEF is effective for both symptom resolution and complete closure of the tracheoesophageal communication.
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