title: Surgical correction of tracheo-oesophageal fistula and oesophageal atresia in infants with VACTERL association: a retrospective case-control study.
abstract: BACKGROUND
  VACTERL is a rare, non-random association comprising at least three major component features defined by the acronym, and including Vertebral anomalies, Anorectal malformations, Cardiac defects, Tracheo-oEsophageal fistula with or without oesophageal atresia (TOF/OA), Renal abnormalities and Limb anomalies. The aim of this study was to compare the post-operative outcomes following surgical correction of TOF/OA in infants with VACTERL and isolated TOF/OA.
  
  
  METHODS
  A retrospective case-control study comparing infants with VACTERL (case group) versus infants with isolated TOF/OA (control group) that underwent surgical correction of TOF/OA at our centre between January 2006 and December 2011. Patient demographics, types of anomalies, operative techniques and post-operative outcomes were collected using inpatient and outpatient records.
  
  
  RESULTS
  We identified 30 consecutive infants with TOF/OA. Five infants had VACTERL (17 %) and 15 infants had isolated TOF/OA (50 %). There was no significant difference in the gestational age (P = 0.79), birth weight (P = 0.69) or operative repair (P = 0.14) between groups. Overall, surgical correction of TOF/OA led to satisfactory morbidity. Infants with VACTERL were not at higher risk of post-operative complications, such as oesophageal stricture (P = 0.17) or gastro-oesophageal reflux (P = 1.0), compared to infants with isolated TOF/OA.
  
  
  CONCLUSIONS
  VACTERL association does not increase the risk of post-operative complications following TOF/OA repair.
authors.affiliation: Department of Paediatric Surgery, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Headley Way, Headington, Oxford, OX3 9DU, UK. robert.morgan@doctors.org.uk
authors.forename: Robert D
authors.initials: RD
authors.lastname: Morgan
authors.forename: John M
authors.initials: JM
authors.lastname: O'Callaghan
authors.forename: Silke
authors.initials: S
authors.lastname: Wagener
authors.forename: Hugh W
authors.initials: HW
authors.lastname: Grant
authors.forename: Kokila
authors.initials: K
authors.lastname: Lakhoo
mesh_terms: D000015:Abnormalities, Multiple; D001003:Anal Canal / Q000002:abnormalities / Q000601:surgery; D001724:Birth Weight; D004933:Esophageal Atresia / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D004947:Esophagus / Q000002:abnormalities / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007668:Kidney / Q000002:abnormalities / Q000601:surgery; D017880:Limb Deformities, Congenital / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013131:Spine / Q000002:abnormalities / Q000601:surgery; D013514:Surgical Procedures, Operative / Q000379:methods*; D015996:Survival Rate / Q000639:trends; D014132:Trachea / Q000002:abnormalities / Q000601:surgery; D014138:Tracheoesophageal Fistula / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D006113:United Kingdom / Q000453:epidemiology