Korean J Pediatr.  2010 Jun;53(6):705-710. 10.3345/kjp.2010.53.6.705.

An 18-year experience of tracheoesophageal fistula and esophageal atresia

• Seo J
• Kim DY
• Kim AR
• Kim DY
• Kim SC
• Kim IK
• Kim KS
• Yoon CH
• Pi SY

• KMID: 2280950
• DOI: http://doi.org/10.3345/kjp.2010.53.6.705

Abstract

PURPOSE
To determine the clinical manifestations and outcomes of patients with tracheoesophageal fistula (TEF) and esophageal atresia (EA) born at a single neonatal intensive care unit.
METHODS
A retrospective analysis was conducted for 97 patients with confirmed TEF and EA who were admitted to the neonatal intensive care unit between 1990 and 2007.
RESULTS
The rate of prenatal diagnosis was 12%. The average gestational age and birth weight were 37(+2) weeks and 2.5+/-0.7 kg, respectively. Thirty-one infants were born prematurely (32%). Type C was the most common. The mean gap between the proximal and distal esophagus was 2 cm. Esophago-esophagostomy was performed in 72 patients at a mean age of 4 days after birth; gastrostomy or duodenostomy were performed in 8 patients. Forty patients exhibited vertebral, anorectal, cardiac, tracheoesophageal, renal, limb (VACTERL) association with at least 2 combined anomalies, and cardiac anomaly was the most common. The most common post-operative complications were esophageal stricture followed by gastroesophageal reflux. Balloon dilatation was performed for 1.3 times in 26 patients at a mean age of 3 months. The mortality and morbidity rates were 24% and 67%, respectively, and the most common cause of death was sepsis. The weight of approximately 40% patients was below the 10th percentile at 2 years of age.
CONCLUSION
Mortality and morbidity rates of patients with TEF and EA are high as compared to those of infants with other neonatal surgical diseases. Further efforts must be taken to reduce mortality and morbidity and improve growth retardation.

Keyword

Tracheoesophageal fistula; Esophageal atresia; VACTERL association; Mortality; Morbidity; Growth

MeSH Terms

Anal Canal
Birth Weight
Cause of Death
Dilatation
Duodenostomy
Esophageal Atresia
Esophageal Stenosis
Esophagus
Extremities
Gastroesophageal Reflux
Gastrostomy
Gestational Age
Heart Defects, Congenital
Humans
Infant
Infant, Newborn
Intensive Care, Neonatal
Kidney
Limb Deformities, Congenital
Prenatal Diagnosis
Retrospective Studies
Sepsis
Spine
Trachea
Tracheoesophageal Fistula
Anal Canal
Esophagus
Heart Defects, Congenital
Kidney
Limb Deformities, Congenital
Spine
Trachea