Congenital oesophageal atresia and tracheo-oesophageal fistula are one of the anomalies that require expert surgical intervention and commitment for correction to achieve a good long-term outcome. Traditionally, the repair is achieved by an open thoracotomy with an extrapleural approach to repair the tracheo-oesophageal fistula and anastomose the oesophagus that has over the years produced good long-term outcomes. However, recent minimally invasive thoracoscopic approach to achieve the same goal is being practised by many skilled surgeons, and they are improving their results by sharing their technical tips. Both these techniques are discussed in this chapter. The complications of the surgery include anastomotic leakage and/or complete dehiscence with resultant mediastinal and pleural infection, pneumothorax, oesophageal stricture, gastro-oesophageal reflux and recurrent trachea-oesophageal fistula. The infants require long-term follow-up by a committed Pediatric surgeon to regularly monitor their growth and developments, swallowing, reflux and acquired spinal abnormalities.
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