Esophageal atresia with distal tracheoesophageal fistula: surgery treatment and a long term follow up

A study carried out at the Paediatric Surgery Units in Siena and Toulouse evaluated the long term follow-up of patients treated for esophageal atresia (EA), between 1988 and 2007. We analyzed the long term follow-up of 57 patients with III type EA. We evaluated the residual symptoms in three time intervals: in 1st years, between 2nd to 5th year and over 5th years from surgery. The considered parameters were: feeding difficulties, respiratory problems, gastro-esophageal reflux, growth impairment, chest anomalies. Feeding difficulty appeared in 26 patients in the 1st year of life, in 28 between the 2nd and 5th year and in 6 after the 5th year. Respiratory problems occurred in 35 children in 1st year, in 30 between the 2nd and 5th year and in 17 after the 5th year. Gastro-esophageal reflux occurred in 30 patients in 1st year, in 22 between the 2nd and 5th year and in 8 over the 5th year. Defects of growth were detected in 17 patients in 1st year of life, in 16 between the 2nd and 5th year and in 5 after the 5th year. Chest anomalies were diagnosed in 7 children. Our analysis established a time limit (5th year postoperatively) over which an undeniable improvement of life quality can be expected.