title: Routine post-operative esophagram Is not necessary after repair of esophageal atresia.
abstract: BACKGROUND
  Esophagrams are routinely performed following repair of esophageal atresia (EA) with or without tracheoesophageal fistula (TEF); however, its utility has not been validated.
  
  
  METHODS
  EA/TEF repair performed from 2003 to 2014 at a single pediatric hospital and from 2004 to 2014 in the Pediatric Health Information System (PHIS) database were retrospectively reviewed to determine utility of esophagrams.
  
  
  RESULTS
  Esophagram was performed in 99% of patients at our institution (N = 105). Clinical signs were seen prior to esophagram in patients whose leak changed clinical management. Esophagram on post-operative day ≤15 was performed in 66% of PHIS database patients (N = 3255). Esophagram did not change the incidence of chest tube placement, reoperation, or dilation. Patients who required a reoperation were less likely to have an esophagram than patients who did not require a reoperation (40.7% versus 65.7%, p < 0.001).
  
  
  CONCLUSIONS
  Our data suggest that routine esophagram is not necessary in asymptomatic patients.
authors.affiliation: Children's Hospital Los Angeles, Division of Pediatric Surgery, 4650 Sunset Blvd, Los Angeles, CA 90027, USA. Electronic address: Jgolden@chla.usc.edu.
authors.forename: Jamie
authors.initials: J
authors.lastname: Golden
authors.affiliation: Children's Hospital Los Angeles, Division of Pediatric Surgery, 4650 Sunset Blvd, Los Angeles, CA 90027, USA. Electronic address: nedemeter@gmail.com.
authors.forename: Natalie E
authors.initials: NE
authors.lastname: Demeter
authors.affiliation: Children's Hospital Los Angeles, Division of Pediatric Surgery, 4650 Sunset Blvd, Los Angeles, CA 90027, USA. Electronic address: Joanna.c.lim@gmail.com.
authors.forename: Joanna
authors.initials: J
authors.lastname: C Lim
authors.affiliation: Children's Hospital Los Angeles, Division of Pediatric Surgery, 4650 Sunset Blvd, Los Angeles, CA 90027, USA. Electronic address: Hford@chla.usc.edu.
authors.forename: Henri R
authors.initials: HR
authors.lastname: Ford
authors.affiliation: Children's Hospital Los Angeles, Division of Pediatric Surgery, 4650 Sunset Blvd, Los Angeles, CA 90027, USA. Electronic address: Jupperman@chla.usc.edu.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Upperman
authors.affiliation: Children's Hospital Los Angeles, Division of Pediatric Surgery, 4650 Sunset Blvd, Los Angeles, CA 90027, USA. Electronic address: Cgayer@chla.usc.edu.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Gayer
mesh_terms: D057868:Anastomotic Leak / Q000000981:diagnostic imaging; D015505:Chest Tubes / Q000706:statistics & numerical data; D004106:Dilatation / Q000706:statistics & numerical data; D004933:Esophageal Atresia / Q000601:surgery*; D004940:Esophageal Stenosis / Q000175:diagnosis; D004947:Esophagus / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011182:Postoperative Care; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014138:Tracheoesophageal Fistula / Q000601:surgery*; D019564:Unnecessary Procedures
keywords: Anastomotic leak; Esophageal atresia; Esophagram; Tracheoesophageal fistula