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Ann Thorac Surg 1979;28:54-59
© 1979 The Society of Thoracic Surgeons

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Articles

Esophageal Atresia and Tracheoesophageal Fistula: Preoperative Assessment and Reduced Mortality

From the Departments of Surgery, Saint Louis University and Cardinal Glennon Memorial Hospital for Children, St. Louis, MO

^* Address reprint requests to Dr. Stothert, Department of Surgery, Saint Louis University, Firmin Desloge Hospital, 1325 S Grand Blvd, St. Louis, MO 63104

One hundred twenty-nine infants with esophageal atresia and tracheoesophageal fistula were reviewed from 1955 to 1978. The overall mortality was 38%. Factors associated with the increased mortality include prematurity, pneumonia, and congenital defects other than this anomaly. A classification based on these factors is introduced, which provides the clinician with a prognostic survival rate greater than 90% with only physical examination, chest and abdominal roentgenography, and intravenous pyelography. Postoperative mortality was reduced to 11% in the last five years of the study; this is attributed to the exclusive use of the retropleural approach to the esophagus, more intensive postoperative ventilatory support, and routine use of parenteral nutrition.

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