J.Jpn. Surg. Soc.. 80(12): 1321-1325, 1979

---

Report on the annual meeting

DELAYED PRIMARY ANASTOMOSIS FOR ESOPHAGEAL ATRESIA WITH TRACHEO-ESOPHAGEAL ATRESIA OF WATERSTON'S POOR RISK GROUP

Forty cases of esophageal atresia with tracheo-esophageal fistula had been reviewed. Survival rate was 76.3 per cent in 38 cases with completed treatment. Twenty five were treated with primary anastomosis and 80 per cent were survived, eight cases with delayed primary anastomosis (gastrostomy and jejunostomy were performed as an initial procedure at admission and division of TEF and esophageal anastomosis were postponed until the procedure could be done safely) and 100 per cent survival rate was obtained, one case with staged procedures with survival and four cases with gastrostomy only with 100 per cent mortality.
Survival rate of seven Waterston's A group was 100 per cent, survival rate of 15 cases with B group 93 per cent, and survival rate of 15 cases with C group 50 per cent.
It is our present conclusion that division of TEF is rarely indicated for treatment of preoperative pulmonary complications, but most of poor risk group can be treated with gastrostomy and feeding jejunostomy as an initial procedures. Division of TEF and esophageal anastomosis (delayed primary anastomosis) can be safely performed in the later period when the patient gains in weight and has no pulmonary complication. However, delayed primary anastomosis does not always give better result in a case with severe associated anomalies.
In the present paper fundamental techniques of primary anastomosis and postoperative complications had been discussed.

---

---

To read the PDF file you will need Adobe Reader installed on your computer.