In this study, doctors from the United States compared the end-to-side repair (ES) with ligation of the tracheoesophageal fistula (TEF) with end-to-end repair of esophageal atresia and distal TEF.
The team evaluated a case series with institutional and historical control subjects.
They assessed 134 infants diagnosed with esophageal atresia and distal TEF between 1968 and 2003.
Overall, 96 infants received ES and 38 end-to-end repair.
The team measured overall survival, surgical complications, and well-being during the first year of life.
|Age-appropriate diet following end-to-side repair was achieved in 93%.|
|Archives of Surgery|
The doctors found that survival was 95% in the ES patients and 90% in the end-to-end repair patients.
They found that complications included anastomotic leak (8% vs 13%), recurrent TEF (7% vs 3%), anastomotic stricture (5% vs 13%), GERD requiring operation (6% vs 18%), and esophageal dysmotility.
Tracheomalacia-related respiratory symptoms following ES decreased from 50% to 11% at 1 year of age.
They established that age-appropriate diet following ES was achieved in 93% by 1 year.
Drs Robert Touloukian and John Seashore concluded, "The ES operation is accompanied by a reduced rate of stricture and gastroesophageal reflux disease requiring operation compared with end-to-end repair".
"Earlier concerns regarding an unacceptable risk of recurrent TEF were not substantiated".