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An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
09:40

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function

Published on: April 17, 2020

Infants with esophageal atresia weighing under 3 pounds

P P Rickham

    Journal of Pediatric Surgery
    |August 1, 1981
    PubMed

    Insights

    Even the smallest infants with esophageal atresia can survive with proper care. Advances in preoperative, operative, and postoperative management have significantly improved survival rates for low birth weight infants.

    Area of Science:

    • Pediatric Surgery
    • Neonatal Care
    • Congenital Malformations

    Background:

    • Esophageal atresia (EA) presents significant challenges in neonates, particularly those with low birth weight.
    • Historically, infants weighing under 3 lb (1360 g) had a poor prognosis.

    Purpose of the Study:

    • To evaluate the survival rates and outcomes of low birth weight infants undergoing surgery for EA.
    • To identify factors influencing survival and propose improved management strategies.

    Main Methods:

    • Retrospective analysis of 339 infants with EA treated between 1953 and the study period.
    • Detailed review of preoperative, operative, and postoperative management, including transport and intensive care.
    • Analysis of surgical techniques and their impact on outcomes.

    Main Results:

    • Only 12 (4%) infants weighed under 3 lb at operation.
    • Before 1957, all infants under 3 lb died; after 1957, five of six infants (between 2-3 lb) survived.
    • The single fatality in the later group was due to an inappropriate surgical approach.

    Conclusions:

    • With meticulous preoperative, operative, and postoperative care, even the smallest infants with EA can survive.
    • Associated malformations, particularly cardiac and neurological, are now the primary determinants of mortality.
    • Infants with extremely low birth weights should achieve normal development following successful EA repair.

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