Esophageal Atresia

Many consider the repair of esophageal atresia and tracheoesophageal fistula the quintessential pediatric surgical operation. While the operation for repair of the most common types is certainly elegant and gratifying, there remain controversies and pitfalls to be considered, and the more uncommon varieties of the disease can be some of the most challenging and demanding problems pediatric surgeons ever deal with in their careers. The diagnostic approach must be systematic and thorough, the surgery precise and well planned, and the follow-up consistent and enduring. Associated anomalies and prematurity are common and can significantly affect prognosis. All patients need to be aggressively treated for gastroesophageal reflux disease (GERD). The two most common complications are anastomotic leak, which usually seals spontaneously with conservative management, and anastomotic strictures, which respond well to balloon dilation and adjuncts. Despite these complications and the fact that all patients have esophageal dysmotility to varying degrees, long-term outcomes are typically excellent.