Congenital tracheoesophageal fistula

Abstract

Study design - Aretrospective analysis of 15 cases of esophageal atresia (EA)/ tracheoesophageal fistula (TEF) to study clinical profile, surgical management, postoperative complications and various factors affecting the outcome. Observation - Associated congenital anomalies were present in 53.33% patients which includes cardiac anomalies, gastrointestinal anomalies etc. VACTERL (vertebral, ano-rectal, cardiac, tracheo-esophageal fistula, esophageal atresia, renal and limb anomalies) was found in 13.33% of cases. Prematurity, associated congenital anomalies, gap between esophageal ends and preoperative respiratory status were the significant factors. Pneumonitis and sepsis were present at time of presentation in 86.66%. Primary transpleural repair was the surgical approach in all. Pneumonitis and sepsis were commonest causes of mortality. Anastomotic leak complicated 13.33% of cases. Survival as per Waterston criteria was 100% in group A, 40% in group B and 0% in group C. Conclusion - Ahigh rate of positive surgical outcome is observed in patient with no associated congenital anomalies, absence of preoperative pneumonia and short gap. Prematurity, low birth weight, low-socio economic status, poor referral, delayed presentation leading to late diagnosis and sepsis are important contributory factors to poor outcome.