Complications After Esophageal Anastomosis in Newborns

Abstract

Esophageal atresia is a congenital anomaly in which the oral end of the esophagus ends in a pouch. Its frequency is 1 in 2500-4500 newborns. Esophageal atresia is considered a complex malformation; the results of its treatment are used to judge the level of surgical care provided by the medical institution. With this malformation, the operation of choice is to perform a primary esophageal anastomosis. Primary anastomosis may be accompanied by severe early and late complications, such as anastomotic leakage, recurrent tracheo-esophageal fistula, esophageal stenosis, the development of reflux esophagitis, etc. However, according to many authors, large diastasis between the segments of the esophagus, concomitant anomalies and body weight less than 1,500 g are obstacles for primary anastomosis. In such situations, the implementation of a delayed esophageal anastomosis or replacement of the esophagus with a large intestine or stomach is recommended. Currently, with the introduction of thoracoscopically performed esophageal anastomosis in newborns, there is an improvement in the results of treatment with esophageal atresia. According to the authors, approximately 75 % of operations for esophageal atresia can be performed thoracoscopically with good results. Progress in thoracoscopic treatment of esophageal defect has significantly improved the quality of life of children after surgical correction of the anomaly.