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Esophageal atresia. A 41-year experience
Archives of Surgery (Chicago, Ill. : 1960)
|April 1, 1979
Summary
Survival rates for infants with esophageal atresia have significantly improved over four decades, reaching 68% in the last ten years. However, high-risk infants still face considerable mortality due to associated conditions.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Congenital Anomalies
Background:
- Esophageal atresia (EA) is a congenital condition requiring surgical repair.
- Long-term outcomes for EA repair have historically varied.
- Improvements in surgical techniques and neonatal care may impact survival rates.
Purpose of the Study:
- To evaluate the trends in treatment outcomes for esophageal atresia over time.
- To assess survival rates and complication frequencies across different decades.
- To identify factors influencing mortality in infants with EA.
Main Methods:
- Retrospective analysis of 365 infants treated for esophageal atresia (EA) with or without tracheoesophageal fistula (TEF).
- Patients were divided into four equal time periods (decades) for outcome comparison.
- Mortality rates were analyzed based on risk groups (A, B, C) in the most recent decade.
Main Results:
- Overall late survival improved from 36-53% to 68% over four decades.
- In the last decade, mortality was 3% for group A, 5% for group B, and 41% for group C infants.
- Anastomotic leaks and recurrent fistulas occurred in approximately 5% of cases across all decades.
- Postoperative stricture was observed in 20% of the entire patient series.
Conclusions:
- Surgical repair of esophageal atresia has shown significant long-term survival improvements.
- Associated anomalies and prematurity remain major contributors to mortality in high-risk infants.
- While complications like leaks and strictures persist, esophageal replacement has not been necessary.