title: Reoperation for anastomotic complications of esophageal atresia and tracheoesophageal fistula.
abstract: OBJECTIVE
  The purpose of the study was to review our experience in the re-operative management of anastomotic complications (ACs) following primary repair of esophageal atresia (EA) and tracheoesophageal fistula (TEF) and to assess the outcomes after reoperation.
  
  
  METHODS
  We retrospectively reviewed 21 EA patients who underwent reoperation from 2005 to 2014. Clinical features, reasons for reoperation, diagnosis of ACs, re-operative procedures and outcomes, as well as long-term follow-up of reoperation were analyzed.
  
  
  RESULTS
  Reoperation occurred in 16 recurrent TEF (RTEF) cases (76.2%), 4 severe anastomotic strictures (AS), and 1 anastomotic leakage (AL) cases (19% and 4.8%, respectively). All of AS and AL were confirmed by esophagography. RTEF were confirmed by esophagoscopy and bronchoscopy. All of the cases underwent reoperation successfully. The average operative time and length of post-operative hospital stay were 2.7 ± 0.8 hours and 15.4 ± 3.3 days, respectively. The mortality rate was 4.8%. All of the cases were followed up from 1 to 107 months after reoperation. No patients experienced respiratory or feeding issues. No severe postoperative complications were shown in all re-operative cases.
  
  
  CONCLUSIONS
  ACs including severe AS and AL as well as RTEF are the significant indications for reoperation after EA repair. The reoperation was effective to treat multiple anastomotic complications.
authors.affiliation: Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai, China.
authors.forename: Haitao
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai, China.
authors.forename: Chun
authors.initials: C
authors.lastname: Shen
authors.affiliation: Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai, China.
authors.forename: Xianmin
authors.initials: X
authors.lastname: Xiao
authors.affiliation: Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai, China.
authors.forename: Kuiran
authors.initials: K
authors.lastname: Dong
authors.affiliation: Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai, China. Electronic address: szheng@shmu.edu.cn.
authors.forename: Shan
authors.initials: S
authors.lastname: Zheng
mesh_terms: D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000601:surgery*; D002675:Child, Preschool; D004933:Esophageal Atresia / Q000601:surgery*; D004940:Esophageal Stenosis / Q000601:surgery*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D014138:Tracheoesophageal Fistula / Q000601:surgery*; D016896:Treatment Outcome
keywords: Anastomotic leakage; Anastomotic strictures; Endoscopy; Esophageal atresia; Recurrent tracheoesophageal fistula; Reoperation