Abstract
Fifteen infants with wide-defect esophageal atresia treated by delayed primary anastomosis since 1975 were reviewed. Nine had an associated tracheoesophageal fistula: 6 lower-pouch.and 3 upper-pouch. All underwent initial gastrostomy and division of a lower-pouch fistula when present. Anastomosis was achieved in all cases at 18–252 days, but with circular myotomy in 4 and upper-pouch elongation in 4. Two had anastomotic leaks and 2 had chylothorax, which all healed with conservative management. Fourteen have needed esophageal dilatation and 2 have had anastomotic strictures resected. One developed an upper-pouch diverticulum, which has been resected. Five had symptomatic gastroesophageal reflux, 2 of whom have had fundoplication. One died from associated severe cyanotic congenital heart disease at the age of 12 months. The 14 survivors are well and making good progress. Delayed primary anastomosis remains our preferred approach for all infants with wide-defect esophageal atresia.
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Correspondence to: M. N. de la Hunt
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de la Hunt, M.N., Fleet, M.S. & Wagget, J. Delayed primary anastomosis for wide-defect esophageal atresia: a 17-year experience. Pediatr Surg Int 9, 21–23 (1994). https://doi.org/10.1007/BF00176100
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DOI: https://doi.org/10.1007/BF00176100