Over the past few weeks, I’ve been on pre and post operative rounds as well as observing surgeries. The progression of the patient goes from diagnosis, tests, operation, to recovery. They’ll keep the patient over night to a few weeks to make sure they are stable and healthy to go home. But upon further reading case studies from my research and other operations, the patient is not always fixed and healthy many months or years later.
I’ve been reading case studies for esophageal atresia (EA) and tracheoesophageal fistula (TEF) and their post operative complications. I have also been comparing different eras to see if surgical techniques have improved in the last decade to minimize post operative complications.
In EA/TEF there are many complications after surgery. One are strictures which means a the intestinal tubes are narrowing. Another are anastomotic leaks when two tubes need are stitched together. Doctors may also miss a fistula which means the connection to the esophagus from the trachea remains. This of course makes it impossible for feeding and breathing to take place.
Of these complications, I’ve found that surgical techniques over the past decade have not improved the overall rate for these complications to a significant value of 0.05. Even with the invention of vicryl sutures which can hold tension for several weeks and floseal which helps build a matrix over the tubes preventing leaks, post operative complications are still high. Many of these are easy fixes; for example, 1-2 dilations will help solve strictures.
Many of these doctors are trying to find better methods to perform these surgeries. They are also hoping for better technology to make their lives easier as well as preventing patient complications. I guess that’s where we come in.