Livaditis myotomy in long-gap esophageal atresia

During 1973 to 1983, Livaditis myotomy was performed on 12 esophageal atresia patients in whom anastomosis otherwise would have been impossible. Ten patients had the usual malformation with a distal fistula, while two had an isolated atresia. Four patients belonged to Waterston's risk group A, 4 to group B, and 4 to group C. In 11 cases anastomosis was permitted by myotomy. In one patient anastomosis was impossible even after myotomy. This baby weighed 1,380 g and she also had trisomy 18 with severe cardiac and renal anomalies leading to death. One patient had a refistula and died of pneumonia, she also had a severe congenital cardiac malformation. There were no anastomotic leakages to free pleural cavity nor complications related to the myotomy. The ten survivors were followed up for a mean period of 5.4 years (range 1.6 to 11.3 years). The subjective results at last follow-up according to the criteria of Desjardins were excellent in eight and good in two patients. Esophagograms showed no strictures, but two patients had a myotomy pouch.