Current knowledge on esophageal atresia

• Published in: World journal of gastroenterology : WJG Vol. 18; no. 28; pp. 3662 - 3672
• Main Authors: Pinheiro, Paulo Fernando Martins, Simões e Silva, Ana Cristina, Pereira, Regina Maria
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Co., Limited 28-07-2012
• Subjects: Adult; Anastomosis, Surgical - methods; Child; Child, Preschool; Esophageal Atresia - diagnosis; Esophageal Atresia - physiopathology; Esophageal Atresia - surgery; Esophageal Stenosis; Esophagus - abnormalities; Esophagus - embryology; Gastroenterology - methods; Gastroesophageal Reflux - diagnosis; Gastroesophageal Reflux - surgery; Humans; Infant; Infant, Newborn; Prognosis; Review; Risk Factors; Surgical Procedures, Operative; Time Factors; Tracheoesophageal Fistula - diagnosis; Tracheoesophageal Fistula - surgery; Treatment Outcome; 功能障碍; 呼吸系统疾病; 手术治疗; 知识; 营养支持; 重症监护; 闭锁; 食管; Esophageal atresia; Esophageal stenosis; Gastro-esophageal reflux; Tracheoesophageal fistula; Long-gap
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v18.i28.3662

Esophageal atresia （EA） with or without tracheoesophageal fistula （TEF） is the most common congenital anomaly of the esophagus. The improvement of survival observed over the previous two decades is multifactorial and largely attributable to advances in neonatal intensive care, neonatal anesthesia, ventilatory and nutritional support, antibiotics, early surgical intervention, surgical materials and techniques. Indeed, mortality is currently limited to those cases with coexisting severe life-threatening anomalies. The diagnosis of EA is most commonly made during the first 24 h of life but may occur either antenatally or may be delayed. The primary surgical correction for EA and TEF is the best option in the absence of severe malformations. There is no ideal replacement for the esophagus and the optimal surgical treatment for patients with long-gap EA is still contro-versial. The primary complications during the postoperative period are leak and stenosis of the anastomosis, gastro-esophageal reflux, esophageal dysmotility, fistula recurrence, respiratory disorders and deformities of the thoracic wall. Data regarding long-term outcomes and follow-ups are limited for patients following EA/TEF repair. The determination of the risk factors for the complicated evolution following EA/TEF repair may positively impact long-term prognoses. Much remains to be studied regarding this condition. This manuscript provides a literature review of the current knowledge regarding EA.