Esophageal atresia and tracheoesophageal fistula: preoperative assessment and reduced mortality.
One hundred twenty-nine infants with esophageal atresia and tracheoesophageal fistula were reviewed from 1955 to 1978. The overall mortality was 38%. Factors associated with the increased mortality include prematurity, pneumonia, and congenital defects other than this anomaly. A classification based on these factors in introduced, which provides the clinician with a prognostic survival rate greater than 90% with only physical examination, chest and abdominal roentgenography, and intravenous pyelography. Postoperative mortality was reduced to 11% in the last five years of the study; this is attributed to the exclusive use of the retropleural approach to the esophagus, more intensive postoperative ventilatory support, and routine use of parenteral nutrition.
D004933:Esophageal Atresia / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008722:Methods; D010288:Parenteral Nutrition; D011182:Postoperative Care; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D012121:Respiration, Artificial; D014138:Tracheoesophageal Fistula / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery