Modern outcomes of oesophageal atresia: Single centre experience over the last twenty years

Aim of the StudyThe aim of this study was assessment of the contemporary outcomes of oesophageal atresia (OA) in a national paediatric surgical centre.Patients and MethodsA review of the hospital records of all patients who underwent repair of oesophageal atresia (OA) in our institute between 1991 and 2011 was performed.ResultsThe study included 130 consecutive infants with OA: types A (n = 4, 3%), B (n = 2, 2%), C (n = 110, 85%), D (n = 5, 4%), and E (n = 9, 7%). Median follow-up was 8.8 (range 0.1–21) years. Twenty-nine (22%) infants had cardiac and 76 (58%) other anomalies, and seventeen (13%) had a long-gap OA. The final repair was primary (n = 113, 87%) or delayed (n = 3) end-to-end anastomosis, oesophageal replacement (n = 8) (6%) with gastric tube (n = 4) or with jejunum interposition (n = 4), and closure of the trachea-oesophageal fistula (Type E, n = 9). Oesophageal continuity was achieved in all patients. Overall mortality was 3/130 (2%) and caused by gastric perforation (n = 1), prolonged apnoeic spell (n = 1), and food asphyxiation (n = 1). Oral feeds were achieved in 121 (94%) children. Eight (6%) children remain dependent on feeding ostomy. Long-gap OA was a major predictor of post-repair complications.ConclusionThe modern outcome for infants with OA is characterized by an extremely low hospital mortality and satisfactory oesophageal function, enabling full oral feeds in the vast majority of children.