Abstract
Between 1980 and 1993, 62 cases of esophageal atresia were treated by the authors with a survival rate of 81%. Of the 17 Waterston A patients, primary anastomosis was done in 12 cases. A simultaneous gastrostomy was performed in the first 2. Of the 15 Waterston B1 and C1 patients, 14 were treated primary anastomosis without gastronomy. Of the 30 Waterston B2 and C2 patients, a preliminary gastrostomy was done in 11 cases for severe pneumonitis or long-gap atresia. The remaining 19 cases were treated by primary anastomosis without gastrostomy. Among the 45 patients treated by primary anastomosis (2 with and 43 without a gastrostomy), there were 6 mortalities, with pneumonia being the cause of death in only 1. We conclude that gastrostomy is contraindicated when primary anastomosis is feasible; primary anastomosis can be done safely in low-birth-weight infants; and the preoperative pulmonary condition can frequently be improved without a decompression gastrostomy
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Abrahamson J, Shandling B (1972) Esophageal atresia in the underweight baby: a challenge. J Pediatr Surg 7: 608–613
Bishop PJ, Klein MD, Philippart AI, Hixson DS, Hertzler JH (1985) Transpleural repair of esophageal atresia without a primary gastrostomy: 240 patients treated between 1951 and 1983. J Pediatr Surg 20: 823–828
Filston HC, Rankin JS, Grimm JK (1984) Esophageal atresia: prognostic factors and contribution of preoperative telescopic endoscopy. Ann Surg 199: 532–537
Holder TM (1993) Esophageal atresia and tracheoesophageal malformations. In: Ashcraft KW, Holder TM (eds) Pediatric surgery, 2nd edn. Saunders WB, Philadelphia, pp 249–269
Lindahl H, Fagerholm R, Louhimo I (1985) Oesophageal atresia in the very low birth weight infant. Mod Probl Paediatr 23: 90–95
Louhimo I, Lindahl H (1983) Esophageal atresia: primary results of 500 consecutively treated patients. J Pediatr Surg 18: 217–229
Myers NA (1974) Oesophageal atresia: the epitome of modern surgery. Ann R Coll Surg Engl 54: 277–287
Pohlson EC, Schaller RT, Tapper D (1988) Improved survival with primary anastomosis in the low birth weight neonate with esophageal atresia and tracheoesophageal fistula. J Pediatr Surg 23: 418–421
Spitz L, Kiely E, Brereton RJ (1987) Esophageal atresia: five year experience with 148 cases. J Pediatr Surg 22: 103–108
Tyson KRT (1976) Primary repair of esophageal atresia without staging or preliminary gastrostomy. Ann Thorac Surg 21: 378–381
Waterston DJ, Bonham-Carter RE, Aberdeen E (1962) Oesophageal atresia: tracheo-oesophageal fistula. A study of survival in 218 infants. Lancet I: 819–822
Yeh ML, Sheu JC, Chang PY, Chen CC (1986) Treatment of esophageal atresia with distal tracheoesophageal fistula: are gastrostomy and prophylactic esophageal dilatation necessary? Int Surg 71: 169–170
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Yen, ML., Wang, NL., Chang, PY. et al. Routine gastrostomy is contraindicated in esophageal atresia. Pediatr Surg Int 10, 90–92 (1995). https://doi.org/10.1007/BF00171162
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DOI: https://doi.org/10.1007/BF00171162