Repair and Complications of Esophageal Atresia and Tracheoesophageal Fistula

Swenson, Orvar; Lipman, Richard M.; Fisher, John H.; DeLuca, Frank G.

doi:10.1056/nejm196211082671904

Cited by 36 publications

(4 citation statements)

References 11 publications

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“…Delay in diagnosis in this series did not affect prognosis, although Hamilton (1969), Swenson et al (1962), and Myers (1974) reported a progressive rise in mortality associated with increasing age at diagnosis, presumably due to pulmonary complications. The review of the American Academy of Pediatrics (Holder et al, 1964) found the worst prognosis in those cases diagnosed on the first day of life.…”

Section: Discussionmentioning

confidence: 54%

Preventable death in oesophageal atresia.

Brereton¹,

Zachary²,

Spitz³

1978

Archives of Disease in Childhood

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SUMMARY We report on experience gained in the treatment of 158 cases of oesophageal atresia presenting during a period of 10 years. The factors influencing mortality were analysed. During the period studied there was a slight improvement in survival, and this was probably due mainly to improved preoperative preparation of those babies undergoing primary repair. At best, 'staging' was thought to have had little influence on the survival of poor risk cases. Midwives, obstetricians, paediatricians, surgeons, and general practitioners did not do all that they could have done to prevent morbidity and mortality in these babies. At least one-third of the 79 deaths could have been prevented, and several deaths were caused solely by lack of awareness of the possible complications and associated abnormalities.Although much progress has been made in the treatment of infants with oesophageal atresia since 1943 (Haight and Towsley), before which time practically all cases died, there is still an unacceptably high mortality rate for 'poor risk' cases. Formerly, technical errors were responsible for many deaths, but advances in operative techniques, preoperative management, and paediatric anaesthesia have succeeded in substantially reducing the overall mortality rate. Since it is unlikely that any new operation of major importance will be developed in the foreseeable future, it is necessary to look to other factors in order to improve survival in these infants, particularly the early nursing and paediatric care, the preoperative management and choice of operation by the surgeon, and the subsequent community and environmental care.

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Section: Discussionmentioning

confidence: 54%

Preventable death in oesophageal atresia.

Brereton¹,

Zachary²,

Spitz³

1978

Archives of Disease in Childhood

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“…If, however, leak occurs, a higher survival rate is noted where the extrapleural route has been employed (Swenson, Lipman, Fisher & DeLuca, 1962;Hays &L Snyder, 1963 ; Holder et a/., 1964). Among these, the way of approach is an issue of continued controversy.…”

Section: Discussionmentioning

confidence: 99%

Esophageal Atresia:II. Anastomotic Disruption Following Primary Surgical Management

Livaditis¹,

Okmian²,

Eklöf³

1969

Scandinavian Journal of Thoracic and Cardiovascular Surgery

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Among 109 patients subjected to primary repair for esophageal atresia, there were 18 who developed anastomotic disruption. This complication occurred within the first week after operation; in 12 cases during the first two postoperative days. In the majority of cases the occurrence of leak was suspected clinically. Radio-IogicaI diagnosis proved more reliable, in some cases preceeding the change in clinical behavior. Treatment consisted in pleural drainage, gastrostomy for decompression, omission of oral feedings and administration of antibiotics in each case. In two patients secondary cervical esophagostomy and closure of the distal segment was performed. Ten patients died within a few days from pulmonary complications and sepsis and two died later from causes unrelated to anastomotic disruption.Of the 6 long-term survivors, 4 developed anastomotic strictures which were successfully treated by dilatations (3 cases) or resection (1 case). The remaining 2 patients made an uneventful recovery. 960-963. Scand J Thor Cardiovasc Surg 3Scand Cardiovasc J Downloaded from informahealthcare.com by McMaster University on 02/03/15For personal use only.

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“…30.7). Esophageal atresia with lower-pouch fistula is by far the most common [40,41]. Esophageal atresia and congenital TEF occur in 1 in 2400 to 1 in 4500 individuals [42].…”

Section: Congenital Tracheoesophageal Fistula and Esophageal Atresiamentioning

confidence: 99%

Esophagus: anatomy and developmental and structural anomalies

Hirano

2008

Textbook of Gastroenterology

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Repair and Complications of Esophageal Atresia and Tracheoesophageal Fistula

Cited by 36 publications

References 11 publications

Preventable death in oesophageal atresia.

Preventable death in oesophageal atresia.

Esophageal Atresia:II. Anastomotic Disruption Following Primary Surgical Management

Esophagus: anatomy and developmental and structural anomalies

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