title: Secondary esophageal surgery following repair of esophageal atresia with distal tracheoesophageal fistula.
abstract: During the period 1948 through 1988, 498 patients with esophageal atresia and distal tracheoesophageal fistula were admitted to the Royal Children's Hospital, Melbourne. Fifty patients had a second operative procedure on the esophagus, for anastomotic stricture (30), recurrent fistula (15), both (4), and a postmyotomy diverticulum (1). During the same period, nine patients underwent esophageal replacement and 33 patients a Nissen fundoplication. Improvements in the technique of esophageal anastomosis, and in recent years the use of fundoplication to correct gastroesophageal reflux have led to a marked reduction in the need for secondary surgery to the esophagus after repair of esophageal atresia. Esophageal replacement is rarely required in esophageal atresia and distal tracheoesophageal fistula. One-layer end-to-end esophageal anastomosis using interrupted sutures resulted in the lowest rate of recurrent fistula and anastomotic stricture.
authors.affiliation: Department of General Surgery, Royal Children's Hospital, Melbourne, Australia.
authors.forename: N A
authors.initials: NA
authors.lastname: Myers
authors.forename: S W
authors.initials: SW
authors.lastname: Beasley
authors.forename: A W
authors.initials: AW
authors.lastname: Auldist
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects; D002675:Child, Preschool; D004933:Esophageal Atresia / Q000150:complications / Q000601:surgery*; D004940:Esophageal Stenosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000601:surgery*; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D014138:Tracheoesophageal Fistula / Q000150:complications / Q000601:surgery*