Comparison of esophageal atresia with and without VACTERL association: A retrospective study

VACTERL association (VA) is a well-known group of congenital defects affecting multiple organs. Although esophageal atresia (EA) has been reported in 50%-80% of patients with VA, only a few studies have compared EA with and without VA.

This retrospective study reviewed the data of patients diagnosed with EA in Seirei Hamamatsu General Hospital between January 2000 and March 2025. The data analyzed included sex, age, anatomic EA type, and VA diagnosis. Data were compared between the patients of EA with VA and those of EA without VA.

During the study period, 37 patients, including 17 male and 20 female patients, were diagnosed with EA; of these, 11 (29.7%) were also diagnosed with VA. The incidence of a long gap was significantly higher in patients of EA with VA (54.5%) than in those of EA without VA (19.2%). The mean age at esophageal reconstruction was significantly higher in patients of EA with VA (208.5 days) than in those of EA without VA (47.2 days).

To the best of our knowledge, this is the first study to report a significantly higher incidence of a long gap in patients of EA with VA compared to those of EA without VA; this result might be associated with a significant difference in the mean age of esophageal reconstruction between the two patient groups. These findings raise the possibility that the incidence of a long gap might be higher in patients of EA with VA than in those of EA without VA.