Management of Esophageal Atresia with Distal Tracheoesophageal Fistula in Ratchaburi Hospital

Abstract

          Sixteen infants of esophageal atresia with distal tracheoesophageal fistula were managed in Pediatric Surgical Unit, Ratchaburi Hospital from October 1987 to April 1993. There were 9 boys and 7 girls. Birth weight ranged from 1800 gm. to 2900 gm. with a mean of 2400 gm. Associated anomalies were present in 7 infants and pneumonia in 15 infants. Preliminary tube gastrostomy was routinely performed under local anesthesia followed by extrapleural right  thoracotomy for immediate primary esophageal repair in 1 infant and delayed primary esophageal repair in 15 infants. The repair consisted of fistula division and one layer end to end esophageal anastomosis. One patient died in immediate postoperative period. Anastomosis leakage occurred in 1 patient and wound infection in 1 patient. There was no esophageal stricture or recurrent tracheoesophageal fistula in the ten patients at follow-up from 3 months to 5 years.