Tracheoesophageal fistula and esophageal atresia repair

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Tracheoesophageal fistula repair - series

This surgery is used to repair two congenital defects of the airway and the digestive tract: tracheoesophageal fistula (TEF) and esophageal atresia. These defects usually occur together, but they may occur separately.

TEF repair; Esophageal atresia repair

Surgery is done while the child is under general anesthesia (unconscious and pain-free). The surgeon makes a cut in the right chest between the ribs. The tracheoesophageal fistula is closed off, then the upper and lower portions of the esophagus are sewn together.

Some infants, such as those who have a low birth weight or other birth defects that cause severe illness, may not be able to have immediate surgery. Surgery will be done after the other problems have been treated or have gone away. In these cases, a gastrostomy tube is placed in the stomach to relieve pressure and prevent fluid from moving up the esophagus and into the trachea. The gastrostomy tube is often placed using local numbing medicines (anesthesia).

In most healthy infants, certain types of TEF are easier to repair after a few months (usually 2 - 4) have passed to allow the baby to grow. During this period, the esophagus may need to be occasionally stretched and widened using an instrument called a dilator. This makes the future repair easier.

TEF and esophageal atresia are life-threatening problems requiring immediate medical attention and treatment. Untreated, saliva and fluids from the gastrointestinal track may be breathed into the lungs (aspirated), which can cause choking. Normal swallowing and digestion of food cannot occur with the abnormal esophagus.

Review Date: 10/16/2006
Reviewed By: J.A. Lee, M.D., Assistant Professor of Surgery, Columbia University Medical Center, New York, NY. Review provided by VeriMed Healthcare Network.