Delayed primary esophageal anastomosis for pure esophageal atresia.

Abstract

PURE ESOPHAGEAL ATRESIA without tracheoeophageal fistula is an uncommon anomaly, comprising 8% of all patients with esophageal atresia, with an expected incidence of 1 in 40,000 live births.l In newborns with pure esophageal atresia, the esophageal segments are too far apart to allow primary anastomosis. In the past, it was customary in these patients to perform a cervical oesophagostomy and gastrostomy soon after birth, followed later by an interposition of colon or stomach. These procedures usually are successful, but the postoperative complications and long-term morbidity can be significant. During the last 3 decades there have been considerable changes in the management of pure esophageal atresia, and it is now widely accepted that delayed primary anastomosis of the esophagus is not only achievable but also the preferred option in the majority of such cases. We have been successful in accomplishing delayed primary anastomosis in all cases of pure esophageal atresia treated at our hospital since 1977 and thus have avoided esophageal replacement.