Esophageal atresia: Five year experience with 148 cases

Esophageal Atresia and Tracheoesophageal Fistula

“…This is different from other series, where it accounts for over 85% of the different types of anomalies. 12,13 This apparent discrepancy in our study is explained by the presence of three infants with EA and both distal and proximal fistula. The combination of EA with proximal fistula is infrequent, occurring in only 0-3% of patients, while EA with both proximal and distal fistula is seen in only 0.25-7.7% of patients.…”

“…Delayed primary esophageal anastomosis is feasible in some of those with long gap between the two esophageal ends, although a high percentage of them develop esophageal stricture. 19,20 Like others, we do not routinely perform gastrostomy in our patients, 12 which has contributed to a low incidence of gastroesophageal reflux. We routinely pass a nasogastric tube before the anastomosis is completed and use this for feeding prior to oral feeding.…”

“…12 The complication rates were anastomotic leak in 21% of the cases, anastomotic stricture in 18% and recurrent TEF in 12%. Our complication rates were anastomotic leak in 13%, and anastomotic stricture in 8.7%.…”

“…5,6,12 Neonates with EA are now diagnosed within a few hours of birth and transferred expeditiously to pediatric surgical centers. Delays in diagnosis in developing countries, however, are reflected in the high incidence of aspiration pneumonitis.…”

“…24 Our overall survival rate of 82.6% is by any standard quite acceptable and comparable to that of developed countries. 12,13,25 Among those who died, two in the group C category had associated life-threatening anomalies and could not be saved in any case. One of them had an associated agenesis of the left hemidiaphragm and in our experience, this anomaly is associated with a severe degree of pulmonary hypoplasia.…”