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| Year : 1997 | Volume
: 2
| Issue : 2 | Page : 83-86 |
Anastomotic leakage following repair of esophageal atresia and tracheo-esophageal fistula.
YK Sarin, L Nambirajan
Pediatric Surgical Unit, Department of Surgery, Christian Medical College, Ludhiana-141008
Correspondence Address:
YK Sarin
Pediatric Surgical Unit, Department of Surgery, Christian Medical College, Ludhiana-141008
 Source of Support: None, Conflict of Interest: None  | Check |
ABSTRACT: Eighty neonates with esophageal atresia and tracheo-esophageal fistula underwent end-to0end esophageal anastomosis. Of these, 15 (18.75 percent) developed anastomotic leakage; all but one had 'major' leaks. Patients with major leaks (n=14) developed respiratory distress with saliva or gastric juice in chest drain within one week of surgery. Only one of these was taken up for re-thoracotomy, others had respositioning of drains and some had extra tubes inserted. Only 2 out of 13 survived the catastrophe. One neonate had a minor radiological leak only and was successfully managed conservatively. Of the various risk factors studied, use of braided silk suture, and distance between esophageal pouches were found to be statistically significant. Livaditi's myotomy was associated with high leak rate, possibly because of learning phase. Retropleural approach was found to have no advantage over transpleural, once a major leak had occurred. We conclude that anastomotic leak following esophageal repair still has high morbidity and mortality and an aggressive surgical intervention is needed for improved outcome.
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