Esophageal atresia and tracheo-esophageal fistula

Abstract

Surgery for esophageal atresia (EA) is regarded as one of the greatest landmarks in newborn surgery. Advances have now led to greater than 95% survival for EA babies managed in the current era with much interest now focusing on health outcome(s), morbidity and quality of life (QoL) of survivors. Classical operation with muscle sparing thoracotomy, axillary skin crease incision and minimally invasive surgery offer a selection of management strategies for the pediatric surgeon and enthusiast alike. Debate continues with regard best practice and expert management of pure [long-gap] esophageal atresia without fistula, medical vs surgical treatment of gastro-esophageal reflux disease (GER), therapies for anastomotic stricture and tracheomalacia. Developmental biology and molecular genetic studies provide fascinating insight into the etiology of EA-TEF, with many key contributions emerging from animal models sharing striking similarity to the human phenotype.