Review
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World J Gastroenterol. Jul 28, 2012; 18(28): 3662-3672
Published online Jul 28, 2012. doi: 10.3748/wjg.v18.i28.3662
Current knowledge on esophageal atresia
Paulo Fernando Martins Pinheiro, Ana Cristina Simões e Silva, Regina Maria Pereira
Paulo Fernando Martins Pinheiro, Regina Maria Pereira, Department of Pediatric Surgery, Odilon Behrens Hospital, Avenida José Bonifácio, São Cristovão, Belo Horizonte, 31210-690 Minas Gerais, Brazil
Ana Cristina Simões e Silva, Department of Pediatrics, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, 30130-100 Minas Gerais, Brazil
Author contributions: Pinheiro PFM, Simões e Silva AC and Pereira RM wrote the review article; Pinheiro PFM and Pereira RM collected data; Pereira RM and Simões e Silva AC analyzed the data.
Supported by Fundação de Amparo à Pesquisa do Estado de Minas Gerais, Brazil; Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil; FAPEMIG: CBB-APQ-00075-09/CNPq 573646/2008-2; and Programa de Grupos de Excelência-FINEP, Brazil
Correspondence to: Ana Cristina Simões e Silva, MD, PhD, Department of Pediatrics, Faculty of Medicine, Federal University of Minas Gerais, Avenue Alfredo Balena, 190, Belo Horizonte, 30130-100 Minas Gerais, Brazil. acssilva@hotmail.com
Telephone: +55-31-78148759 Fax: +55-31-30248687
Received: May 30, 2011
Revised: August 26, 2011
Accepted: June 8, 2012
Published online: July 28, 2012
Abstract

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 controversial. 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.

Keywords: Esophageal atresia; Tracheoesophageal fistula; Esophageal stenosis; Long-gap; Gastro-esophageal reflux