title: Esophageal atresia with or without tracheoesophageal fistula: success and failure in 94 cases.
abstract: BACKGROUND
  The management of newborns with esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) has evolved considerably over the years. Currently an overall survival of 85% to 90% has been reported from developed countries. In developing countries, several factors contribute to higher mortality rates. We describe our experience with 94 consecutive cases of EA with or without TEF.
  
  
  METHODS
  We retrospectively studied 94 patients with EA with or without TEF treated at our hospital over a period of 15 years. Medical records were reviewed for age at diagnosis, sex, birth weight, associated anomalies, aspiration pneumonia, method of diagnosis, treatment, postoperative complications and outcome.
  
  
  RESULTS
  Ninety-four newborns (55 males and 39 females) with EA/TEF were treated at our hospital. Their mean birth weight was 2.2 kg (700 g to 3800 g). Age at diagnosis ranged from birth to 7 days. At the time of admission 37 (39.4%) had aspiration pneumonia. Associated anomalies were seen in 46 (49%) patients. Thirteen patients had major associated anomalies that contributed to mortality. Postoperative complications were similar to those from developed countries but overall operative mortality (30.8%) was high.
  
  
  CONCLUSIONS
  The overall mortality was high but excluding major congenital malformations, sepsis was the most frequent cause of death. Factors contributing to mortality included prematurity, delay in diagnosis with an increased incidence of aspiration pneumonia and a shortage of qualified nurses. To improve overall outcome, factors contributing to sepsis should be evaluated and efforts should be made to overcome them.
authors.affiliation: Department of Pediatric Surgery, Maternity and Children Hospital, Dammam, Saudi Arabia. ahalsalem@hotmail.com
authors.forename: Ahmed H
authors.initials: AH
authors.lastname: Al-Salem
authors.forename: Maaen
authors.initials: M
authors.lastname: Tayeb
authors.forename: Suzi
authors.initials: S
authors.lastname: Khogair
authors.forename: Anita
authors.initials: A
authors.lastname: Roy
authors.forename: Nuhad
authors.initials: N
authors.lastname: Al-Jishi
authors.forename: Kefah
authors.initials: K
authors.lastname: Alsenan
authors.forename: Hussain
authors.initials: H
authors.lastname: Shaban
authors.forename: Muzaffar
authors.initials: M
authors.lastname: Ahmad
mesh_terms: D004933:Esophageal Atresia / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014138:Tracheoesophageal Fistula / Q000151:congenital / Q000401:mortality / Q000601:surgery*