Tuesday, July 17, 2007

Esophageal Atresia Surgery

I was able to observe an esophageal atresia (EA) /tracheoesopheal (TE) fistula surgery. This was important to me because (1) the patient has been in the hospital for a month recovering from her open heart surgery before undergoing the EA/TEF surgery, and (2) these are the types of cases my research involves. This entry details the surgery I observed on Monday.

But first I’ll explain the background once again. EA and TE fistula is a congenital disease where the esophagus and trachea do not separate. Instead, you can get variations of this disease. For example, most patients (86%) have the variation when the upper esophagus pouch ends close to the trachea and a fistula is present at the distal end of the trachea connecting to the esophagus.


Other variations include no fistula, or only a fistula. You can get a proximal TE fistula or even a double fistula at the proximal and distal ends. These variations are rare and make up for the last 14% combined.

Now for the surgery:

The procedure is relatively simple, as the mortality rate is much lower than in the past.


To repair esophageal atresia, an opening is cut into the chest (A). The two parts of the existing esophagus are identified (B). The lower esophagus is detached from the trachea (C) and connected to the upper part of the esophagus (D). The wound in the trachea is closed, and the chest incision is repaired.

In our case, an interposition colon procedure was unnecessary. The patient's esophagus was able to overcome the wide gap and connect together. This is called an esophagoesophageal anastomoses. Otherwise, a section of the colon will have to be placed in the gap between the two ends of the esophagus. The procedure went well and the patient is recovering.

1 comment:

mike said...

Hey if you wanted any information on Type A or B EA / TEF I Suggest you research a bit about the Foker Method. This is a very rare procedure as only 30 cases a year of EA are Long Gap and require this kind of procedure. My son has Type A Long Gap and the distance between is distal / proximal pouches was 4.3cm. For more info I have a blog setup as well for Aidan at http://kiczek.blogspot.com