J Korean Surg Soc.  2012 Jul;83(1):43-49. 10.4174/jkss.2012.83.1.43.

Clinical characteristics and treatment of esophageal atresia: a single institutional experience

Affiliations
  • 1Department of Pediatric Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea. jtoh@yuhs.ac

Abstract

PURPOSE
Treatment for esophageal atresia has advanced over several decades due to improvements in surgical techniques and neonatal intensive care. Subsequent to increased survival, postoperative morbidity has become an important issue in this disease. The aim of our study was to analyze our experience regarding the treatment of esophageal atresia.
METHODS
We reviewed and analyzed the clinical data of patients who underwent surgery for esophageal atresia at Severance Children's Hospital from 1995 to 2010 regarding demographics, surgical procedures, and postoperative outcomes.
RESULTS
Seventy-two patients had surgery for esophageal atresia. The most common gross type was C (81.9%), followed by type A (15.3%). Primary repair was performed in 52 patients. Staged operation was performed in 17 patients. Postoperative esophageal strictures developed in 43.1% of patients. Anastomotic leakages occurred in 23.6% of patients, and recurrence of tracheoesophageal fistula was reported in 8.3% of patients. Esophageal stricture was significantly associated with long-gap (> or =3 cm or three vertebral bodies) atresia (P = 0.042). The overall mortality rate was 15.3%. The mortality in patients weighing less than 2.5 kg was higher than in patients weighing at least 2.5 kg (P = 0.001). During the later period of this study, anastomotic leakage and mortality both significantly decreased compared to the earlier study period (P = 0.009 and 0.023, respectively).
CONCLUSION
The survival of patients with esophageal atresia has improved over the years and the rate of anastomotic leakage has been significantly reduced. However, overall morbidities related to surgical treatment of esophageal atresia still exists with high incidence.

Keyword

Esophageal atresia; Tracheoesophageal fistula; Prognosis; Survival

MeSH Terms

Anastomotic Leak
Constriction, Pathologic
Demography
Esophageal Atresia
Esophageal Stenosis
Humans
Incidence
Infant, Newborn
Intensive Care, Neonatal
Prognosis
Recurrence
Tracheoesophageal Fistula
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