Performing an early (within 10 week) esophagogram and endoscopic dilatation after surgical correction of Type III esophageal atresia

Abstract

Aim: Esophageal atresia (EA) is complicated by a high incidence of gastroesophageal reflux (GER) and anastomotic stricture. Active management in the form of early esophagoscopy at two months may aid in reducing mortality and long-term morbidity in these patients. Methods: Neonates undergoing primary anastomosis for type C esophageal atresia were prospectively enrolled and followed up in the study. Contrast esophagography and esophagoscopy were performed at one to two months of age to diagnose GER and esophageal stricture early. Results: Among the 64 patients presenting with esophageal atresia, 57 underwent primary esophageal anastomosis at the neonatal age. Thirty-two neonates survived out of the 50 who had follow-up for at least 270 days were included. Anastomotic stricture was seen in 11 out of 32 (34%) infants. Ten of these could be dilated, requiring 1-7 (median 2) dilatations, and one needed surgical resection and redo-anastomosis. Conclusion: Aggressive diagnosis, management of anastomotic stricture by early esophagoscopy is required to avert long-term issues in survivors of esophageal atresia.