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April 1961

Atypical Congenital Atresia of the Esophagus: Treatment of This Anomaly by Means of Retrosternal Colon Transplant

Author Affiliations

Assistant Clinical Professor of Surgery, College of Medical Evangelists School of Medicine, Los Angeles.

Arch Surg. 1961;82(4):515-527. doi:10.1001/archsurg.1961.01300100029003

Alert recognition and increased skill and experience in surgery, anesthesia, and postoperative care have made the treatment of congenital esophageal atresia more rewarding in recent years. The history of the early recognition and attempts at surgical treatment of congenital esophageal atresia is fascinating and has been fully covered in many review articles.* Primary transthoracic or extrapleural anastomosis has become the standard procedure for the usual type of atresia with distal tracheoesophageal fistula since Cameron Haight's first successful case operated on in March, 1941. The mortality associated with this type of anomalous esophagus remains between 40% and 50% (see the table), primarily because of the factors of delayed diagnosis, the frequency of associated serious congenital defects (30%), and high incidence of prematurity (40%).

The development of operative techniques which safely and adequately reconstruct the esophagus in cases in the approximately 10% of these newborn infants in which no primary anastomosis can