Abstract
The aim of the study was to evaluate the outcome of primary repair of oesophageal atresia (OA)/tracheo-oesophageal (TOF) using an anterior flap from the upper pouch to relieve tension on the anastomosis. Of 66 patients with OA/TOF managed in this institution in the period 1977–1993, only 1 (1.5%) had a colonic interposition. There were 15 (10 long-gap OA) primary repairs with an anterior flap. Median follow-up was 2 years (range 11 months – 16 years). Complications included anastomotic leaks in 4 (27%), anastomotic strictures in 13 (87%), of which 2 (13.3%) required resection, gastro-oesophageal reflux in 9 (60%), of which 3 (20%) required fundoplication, recurrent TOF in 2 (14%), and oesophageal incoordination in 6 (40%). Median hospital stay was 77 days (range 18–240 days). There were 3 late deaths (12, 12, 14 months). Of 12 survivors, 8 (66.7%) achieved normal growth. In addition, 3 patients had a myotomy as well as a flap (anastomotic leak 2, stricture 3). We conclude that the anterior flap technique for repair of OA/TOF reduces the need for oesophageal replacement. There is considerable morbidity associated with its use in these high-risk patients, but a satisfactory outcome can be achieved in long-term survivors.
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Brown, A.K., Gough, M.H., Nicholls, G. et al. Anterior flap repair of oesophageal atresia: a 16-year evaluation. Pediatr Surg Int 10, 525–528 (1995). https://doi.org/10.1007/BF00566488
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DOI: https://doi.org/10.1007/BF00566488