Abstract
A prospective trial was undertaken to assess the need for routine gastrostomy in the management of the infant with oesophageal atresia. Over a 34-month period, 51 infants with oesophageal atresia and distal tracheo-oesophageal fistula were assigned to either gastrostomy or transanastomotic tube group. The two groups were similar in terms of birth weight, gestational age, risk group, associated anomalies, and anastomotic tension. There was no difference in the number of anastomotic leaks or strictures. The incidence of significant gastro-oesophageal reflux was 72% (n=18) in the gastrostomy group compared with 30% (n=8) in the transanastomotic tube group. forty-four per cent (n=10) of the former required antireflux surgery compared with 15% (n=4) in the latter group. The conclusion was that routine gastrostomy is unnecessary in the management of infants with oesophageal atresia and may be positively harmful in promoting gastro-oesophageal reflux.
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