Castilloux et al reported risk factors for short and long-term morbidity following surgical correction of esophageal atresia in an infant. About half of the patients undergoing surgery develop one or more complications, some of which may be life-threatening. The authors are from Universite de Montreal in Quebec.
Complication selection: significant enough to require therapeutic intervention and/or negatively impact the patient’s or family’s quality of life
Complications that may develop following surgery for esophageal atresia:
(1) severe gastroesophageal reflux
(2) esophageal stricture requiring more than 1 dilatation
(3) recurrent tracheoesophageal fistula requiring surgery
(4) need for gavage feedings for 3 or more months
(5) severe tracheomalacia
(6) severe chronic respiratory disease (from aspiration, etc)
where:
• Severe gastroesophageal reflux was defined by moderate to severe esophagitis, need for fundoplication, need for jejunal feedings, and/or Barrett’s metaplasia.
• Severe tracheomalacia was defined the presence of cyanotic spells, changes seen on bronchoscopy, need for aortopexy and/or need for tracheostomy.
Late complications may include:
(1) Barrett’s esophagus with dysplasia
(2) malignancy (esophageal adenocarcinoma or squamous cell carcinoma)
(3) death
