Esophageal Atresia and Tracheoesophageal Fistula: Surgical Experience Over Two Decades

Tsai, Josephine Y; Berkery, Leah; Wesson, David E.; Redo, S. Frank; Spigland, Nitsana

doi:10.1016/s0003-4975(97)00752-2

Cited by 91 publications

(68 citation statements)

References 22 publications

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“…We suggest that given the magnitude of the initial problem, reflux and strictures represent the minimum that could be expected from a true primary repair. The extra procedures required seem reasonable in attaining a functioning native esophagus, particularly when compared to the results with interposi- 5,[8][9][10][11]37,38,41,42,49 tions. ' In summary, we found that the entire spectrum of gap lengths, even ultra-long gaps, could be successfully repaired primarily.…”

Section: Discussionmentioning

confidence: 99%

Development of a True Primary Repair for the Full Spectrum of Esophageal Atresia

et al. 1997

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ObjectiveTo determine whether or not a true primary repair, without myotomies and with the gastroesophageal junction below the diaphragm, can be accomplished across the esophageal atresia (EA) spectrum. Our hypothesis is that the esophageal anastomosis can withstand significant tension. The consequences, particularly for those patients with a very long gap atresia, were assessed. Summary of Background DataDifficulties arise roughly in proportion to the size of the gap between esophageal segments. Reported surgical complications remain frequent, and particularly at the far end of the EA spectrum, not all children are left with a satisfactorily functioning esophagus or esophageal substitute. MethodsThe outcomes of all infants who had a true primary repair of EA from 1976-1997 were determined. Surgically, the methods used to achieve a reliable true primary repair were expanded to accomplish this, even for a very long gap EA. ResultsFrom 1976-97, 70 infants with or without associated tracheoesophageal fistula (TEF) had primary repairs performed with no surgery-related deaths and 11 % later deaths. No interpositions were performed since 1983. There were no discernible anastomotic leaks and one late recurrent TEF related to the early use of balloon dilation. Ten infants had gaps of 5.0-6.8 cm and, among these, four had gaps of 5.5-6.8 cm that could not be pulled together initially. Traction sutures in the esophageal ends, however, produced sufficient lengthening within 6-10 days for a true primary repair. Very long gap repairs produced more reflux (10 of 10 required a fundoplication versus 24 of 70 overall) and more dilations to relieve strictures. Two infants underwent stricture resection with no recurrence. On follow-up, all patients over 2 years of age were eating well or satisfactorily, and none had a gastrostomy tube. Conclusions(1) The esophageal anastomosis can withstand considerable tension and allows a reliable true primary repair for the full EA spectrum. (2) Growth is rapid and traction sutures will 533

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Section: Discussionmentioning

confidence: 99%

Development of a True Primary Repair for the Full Spectrum of Esophageal Atresia

et al. 1997

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“…Left cervical oesophagostomy and feeding gastrostomy (using Fr 10G Foley's catheter) without thoracotomy was done for pure oesophageal atresia without tracheo-oesophageal fistula in 11 patients. (13) Post-Operative Management Includes oxygenation by facemask or 'T' piece, gentle throat clearance, saline nebulization and gentle chest physiotherapy. Expressed breast milk feeding was initiated through transanastomotic nasogastric tube from 2nd day onwards and gradually increased.…”

Section: Surgical Proceduresmentioning

confidence: 99%

“…Primary gastric pull up. (13) was done in one patient. Xipho-omphalopagus conjoined twin with oesophageal atresia and tracheo-oesophageal fistula in one baby was operated for the anomaly immediately after separation of the twin.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Oesophageal Atresia: 10 Years Study

Rao¹,

Komma²,

Subbarao³

et al. 2016

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Outcome of oesophageal atresia with tracheo-oesophageal fistula and oesophageal atresia without tracheo-oesophageal fistula in Guntur Medical College and Government General Hospital, Guntur, without ventilatory support over a period of ten years (2004 to 2014) was highlighted. Oesophageal atresia is considered to be a touch stone in paediatric surgery. Total 269 patients were treated; 223 patients underwent surgery out of 269; 136 patients survived (61%) with few long term complications. (1)

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“…The incidence of H-type TEF accounts for about 4% of tracheoesophageal abnormalities with an incidence of about 1 per 100 000 births. 1,2 The clinical diagnosis of an H-type TEF has been associated with the triad of paroxysms of coughing or cyanosis with feeding, gaseous distension of the gastrointestinal tract and recurrent pneumonia or bronchitis. Performance of an esophagogram and bronchoscopy are eventually diagnostic.…”

Section: Introductionmentioning

confidence: 99%

H-type tracheoesophageal fistula in an extremely low birth weight premature neonate: appearance on magnetic resonance imaging

et al. 2009

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Esophageal Atresia and Tracheoesophageal Fistula: Surgical Experience Over Two Decades

Cited by 91 publications

References 22 publications

Development of a True Primary Repair for the Full Spectrum of Esophageal Atresia

Development of a True Primary Repair for the Full Spectrum of Esophageal Atresia

Oesophageal Atresia: 10 Years Study

H-type tracheoesophageal fistula in an extremely low birth weight premature neonate: appearance on magnetic resonance imaging

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