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May 1964

Recommunication on Repair of Congenital Tracheoesophageal Fistula: Report of a Case and Review of Literature

Author Affiliations

Formerly, Senior Resident, Department of Surgery, Youngstown Hospital Association, Youngstown, Ohio. He is currently (in private practice) a Member, Associate Surgical Staff, South Highlands Infirmary and Courtesy Surgical Staffs of the Birmingham Baptist Hospitals and East End Memorial Hospital.

Arch Surg. 1964;88(5):779-786. doi:10.1001/archsurg.1964.01310230055012

The surgical problem of congenital esophageal atresia with or without tracheo-esophageal fistula has been partially solved through the work of Leven, Haight, and others. There are many excellent reviews of the subject covering more than 1,000 well studied cases.* Transpleural or extrapleural division and primary closure of the fistula with end-to-end reconstruction of the esophagus, has been employed by most authors as the procedure of choice. With increasing experience and improved methods of postoperative care, salvage has increased, but the mortality rate still remains quite high. Many other surgeons have treated certain selected cases by staged procedures. Cervical esophagostomy, gastrostomy, and division and closure of the fistula are performed initially. Various methods of reconstruction are employed as additional stages, such as transplantation of small or large bowel segments, or construction of a substitute esophagus with a skin tube.4,6,8,15,28,32,37

Many factors, such as the infant's preoperative weight and general condition,

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