Pediatric Surgery International

, Volume 2, Issue 4, pp 216–222 | Cite as

Oesophageal atresia without fistula — anastomosis or replacement?

  • N. A. Myers
  • S. W. Beasley
  • A. W. Auldist
  • M. Kent
  • V. Wright
  • P. Chetcuti
Main Topic


At the Royal Children's Hospital, Melbourne, 553 babies with oesophageal atresia and/or tracheo-eesophageal fistula have been admitted during the past 39 years; 36 (6.5%) of these had oesophageal atresia without a tracheo-oesophageal fistula. Definitive surgery was performed in 27 patients: the primary definitive procedure was oesphageal anastomosis in 15 and oesophageal replacement in 12. Aspects of diagnosis and selection of the most appropriate treatment modality are discussed, with the results of treatment presented. Our current policy is to perform an oesphhageal anastomosis whenever possible, and this has been successful in 7 of the last 11 patients.

Key words

Oesophageal atresia Gasless abdomen Oesophageal replacement Long gap 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Aberdeen E, Myers NA (1979) The esophagus. In: Ravitch MM (eds) Pediatric Surgery, 3rd edn. Year Book Medical Publishers, Chicago, 450Google Scholar
  2. 2.
    Ahmed S (1972–1974) Congenital tracheo-oesophageal fistula without atresia (H-fistula). South Australian Clinics 6: 388–391Google Scholar
  3. 3.
    Anderson KD (1984) Esophageal substitution. Proceedings of International Congress of Paediatric Surgery, PerthGoogle Scholar
  4. 4.
    Anderson KD (1984) Oesophageal substitution. Aust NZ J Surg 54: 447–449Google Scholar
  5. 5.
    Atwell KD, Beard RC (1974) Congenital anomalies of the upper urinary tract associated with oesophageal atresia and tracheo-oesophageal fistula. J Pediatr Surg 9: 825–831Google Scholar
  6. 6.
    Bishop PJ (1985) Transpleural repair of oesophageal atresia without a primary gastrostomy: 240 patients treated between 1951 and 1983. J Pediatr Surg 6: 823–828Google Scholar
  7. 7.
    Booss D, Hollwarth M, Sauer H (1982) Endoscopic esophageal anastomosis. J Pediatr Surg 17: 138–143Google Scholar
  8. 8.
    Cass D, Auldist AW (1987) Oesophageal atresia with proximal tracheo-oesophageal fistula. Pediatr Surg Int 2: 212–215Google Scholar
  9. 9.
    Cohen D (1970) Oesphaggeal reconstruction using a gastric tube: a preliminary report. Aust Paediatr J 6: 22–24Google Scholar
  10. 10.
    Cihen SJ (1965) Unusual types of oesophageal atresia and tracheo-oesophageal fistula. Diagnostic aids and procedures. Clin Pediatr 4: 271–275Google Scholar
  11. 11.
    Cumming WA (1975) Esophageal atresia and tracheo-oesophageal fistula. Radiol Clin North Am 13: 277–295Google Scholar
  12. 12.
    Foker JE, Ring WS, Varco Rl (1982) Technique of jejunal interposition for esophageal replacement. J Thorac Cardiovasc Surg 83: 928–933Google Scholar
  13. 13.
    Freeman NV, Cass DT (1982) Colon interposition: a modification of the Waterston technique using the normal oesophageal route. J Pediatr Surg 17: 17–21Google Scholar
  14. 14.
    Haight C (1957) Some observations on esophageal atresia and tracheoesophageal fistulas of congenital origin. J Thorac Surg 34: 141–172Google Scholar
  15. 15.
    Haight C (1969) Congenital oesophageal atresia and tracheo-oesophageal fistula. In: Mustard WT eds, Pediatric surgery, 2nd Edn., Year Book Medical Publishers, Chicago, pp 357–358Google Scholar
  16. 16.
    Hamilton JP (1966) Esophageal atresia. Technical points in the staged procedures leading to esophageal anastomosis. J Pediatr Surg 1: 253–255Google Scholar
  17. 17.
    Hays DM, Woolley MM and Snyder WH (1966) Esophageal atresia and tracheo-esophageal fistula: management of the uncommon types. J Pediatr Surg 1: 240–252Google Scholar
  18. 18.
    Hendren WH, Hale JR (1975) Electromagnetic bougienage to lengthen esophageal segments in congenital esophageal atresia. N Engl J Med 293: 428–432Google Scholar
  19. 19.
    Holden MP, Woller GN (1970) Tracheo-oesophageal fistula and oesophageal atresia: results of 30 years experience. Thorax 25: 406–412Google Scholar
  20. 20.
    Holder TM (1964) Esophageal atresia and tracheo-esophageal fistula. A survery of its members by the Surgical Section of the American Academy of Pediatrics. Pediatrics 34: 542–549Google Scholar
  21. 21.
    Howard R, Myers NA (1965) Oesophageal atresia: a technique for elongating the upper pouch. Surgery 58: 725–727Google Scholar
  22. 22.
    Koop CE, Hamilton JP (1965) Atresia of the esophagus. Increased survival with staged procedures in the poor-risk infant. Ann Surg 162: 389–401Google Scholar
  23. 23.
    Livaditis A (1973) Esophageal atresia; a method of overbridging large segmental gaps. Z Kinderchir 13: 298–306Google Scholar
  24. 24.
    Louhimo I, Lindahl H (1983) Esophageal atresia. Primary results of 500 consecutively treated patients. J Pediatr Surg 18: 217–299Google Scholar
  25. 25.
    Myers NA (1974) Oesophageal atresia: the epitome of modern surgery. Ann R Coll Surg Engl 54: 277–287Google Scholar
  26. 26.
    Myers NA (1984) The long gap in oesophageal atresia. Why not the oesophagus? Proceedings of International Congress of Paediatric Surgery, PerthGoogle Scholar
  27. 27.
    Puri P (1981) Delayed primary anastomosis following spontaneous growth of esophageal segments in esophageal atresia. J Pediatr Surg 16: 180–183Google Scholar
  28. 28.
    Randolph J (1986) In: Welch (eds) Pediatric surgery, p 682Google Scholar
  29. 29.
    Rehbein F, Schweder N (1971) Reconstruction of the esophagus without colon transplantation in cases of atresia. J Pediatr Surg 6: 746–752Google Scholar
  30. 30.
    Rehbein F, Schweder N (1972) Neue Wege in der Rekonstruktion der kindlichen Speiseröhre. Dtsch Med Wochenschr 97: 757–770Google Scholar
  31. 31.
    Ricketts RR, Luck SR, Raffensperger JG (1981) Circular esophagomyotomy for primary repair of long-gap esophageal atresia. J Pediatr Surg 16: 365–369Google Scholar
  32. 32.
    Ring WS (1982) Esophageal replacement with jejunum in children: an 18- to 33-year follow up. J Thorac Cardiovasc Surg 83: 918–927Google Scholar
  33. 33.
    Roberts KD (1958) Congenital oesophageal atresia and tracheo-oesophageal fistula. Thorax 13: 116–129Google Scholar
  34. 34.
    Rosselo PJ, Lebrow H, France AAR (1980) The technique of myotomy in esophageal reconstruction. Anexperimental study. J Pediatr Surg 15: 430–432Google Scholar
  35. 35.
    Swenson O (1958) Pediatric Surgery, 2nd edn., Appleton-Century-Crofts, New York, p 155Google Scholar
  36. 36.
    Takada Y, Kent G, Filler RM (1981) Circular myotomy and esophageal length and safe esophageal anastomosis. An experimental study. J Pediatr Surg 16: 343–348Google Scholar
  37. 37.
    Vizas D, Ein SH, Simpson JS (1978) The value of circular myotomy for esophageal atresia. J Pediatr Surg 13: 357–359Google Scholar
  38. 38.
    Waterson DJ, Bonham-Carter RE, Aberdeen E (1963) Congenital tracheo-oesophageal fistula in association with oesophageal atresia. Lancet 2: 55–57Google Scholar
  39. 39.
    Zigiotti GL, Domini R (1974) La miotomia cincolare del moncone superiore secondo livaditis nell' anastomosis primara per atresia esofager. Riv Chir Pediatr 16: 49Google Scholar

Copyright information

© Springer-Verlag 1987

Authors and Affiliations

  • N. A. Myers
    • 1
  • S. W. Beasley
    • 1
  • A. W. Auldist
    • 1
  • M. Kent
    • 1
  • V. Wright
    • 1
  • P. Chetcuti
    • 1
  1. 1.Department of SurgeryRoyal Children's HospitalParkvilleAustralia

Personalised recommendations