CPT® Code 43314

Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; with repair of congenital tracheoesophageal fistula

Esophagoplasty is a surgical procedure aimed at the plastic repair or reconstruction of the esophagus, particularly in cases involving congenital defects. This procedure is performed through a thoracic approach, typically utilizing a right posterolateral thoracotomy. During the operation, the surgeon makes an incision in the skin and extends it through the underlying soft tissues to access the thoracic cavity. The scapula is retracted to facilitate entry into the thorax while ensuring that the pleura, the membrane surrounding the lungs, remains undisturbed. The surgical team conducts a retropleural dissection, retracts the lung, and carefully exposes the esophagus to identify the defect that requires repair. In cases where a tracheoesophageal fistula is present, as indicated by CPT® Code 43314, the procedure involves additional steps to address this specific condition. The fistula, an abnormal connection between the trachea and esophagus, is divided, and the trachea is repaired using sutures. The esophagus is then reconstructed in two layers, with the suture line reinforced by utilizing a flap of mediastinal pleura, intercostal muscle, and rib periosteum as necessary. This comprehensive approach ensures that both the esophageal defect and the associated tracheoesophageal fistula are effectively managed, promoting optimal healing and function of the esophagus post-surgery.