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Updated: May 20, 2026

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
[Esophageal atresia]
F Gottrand1, R Sfeir, C Thumerelle
1Centre de référence des affections congénitales et malformatives de l'œsophage, faculté de médecine, université de Lille 2, pôle enfant, hôpital Jeanne-de-Flandre, 59037 Lille, France. frederic.gottrand@chru-lille.fr
Insights
Children operated for esophageal atresia often face long-term issues like reflux and dysphagia. Regular, lifelong follow-up is crucial for managing these frequent esophageal atresia complications.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Pulmonology
Context:
- Esophageal atresia (EA) repair allows survival, but long-term sequelae are common.
- Gastroesophageal reflux disease (GERD) affects a significant portion, leading to esophagitis and stenosis.
- Tracheomalacia is prevalent, posing risks for respiratory distress.
Purpose:
- To review the medium-term and late complications following surgical repair of esophageal atresia.
- To highlight the frequency and impact of gastrointestinal, respiratory, and growth issues.
- To emphasize the need for ongoing multidisciplinary care.
Summary:
- Post-EA surgery, common complications include GERD (26-75%), dysphagia (up to 45% by age 5), and growth retardation (nearly 33% by age 5).
- Respiratory issues like tracheomalacia (75% at birth) and chronic cough are frequent, though often improve.
- These complications moderately impair quality of life, necessitating lifelong monitoring.
Impact:
- Identifies critical areas for long-term management of EA patients.
- Underscores the importance of multidisciplinary follow-up into adulthood.
- Provides data on complication rates to inform clinical practice and patient counseling.
Abstract:
Most of the children operated for esophageal atresia will survive the neonatal period. However, medium-term and late complications are frequent in this population. Gastroesophageal reflux disease is observed in 26 to 75% of the cases and can be responsible for peptic esophagitis, anastomotic stenosis, and Barrett esophagus, which is a risk factor for adenocarcinoma of the esophagus. Dysphagia is frequently observed, sometimes several years after the surgery, affecting up to 45% of children at the age of 5 years. Growth retardation is present in nearly one-third of children at the age of 5 years. Ear, nose, and throat and respiratory complications are also very frequent but tend to improve with time. Tracheomalacia is found in 75% of these children at birth, sometimes responsible for severe complications (malaise, bradycardia). Respiratory symptoms are dominated by chronic cough, wheezing, and infections reported in 29% of the children by the age of 5 years. Restrictive, obstructive syndromes and bronchial hyperactivity can be observed, but usually remain moderate. All these complications can influence the patient's quality of life, which is moderately impaired compared to healthy controls. The high frequency of late sequelae in esophageal atresia justifies regular and multidisciplinary follow-up through adulthood.
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