Esophageal Atresia and Tracheoesophageal Fistula

The term congenital atresia of the esophagus describes a large group of variant malformations that share a defect of the esophageal continuity with or without a fi stula to the trachea or to the bronchi. It is one of the most life-threatening anomalies in a newborn baby and the quality of survival depends on early diagnosis and appropriate therapy. The fi rst successful surgery of a 12-day-old female baby was performed by Cameron Haight at the University of Michigan in 1941. Now an adult, this patient gave birth to a newborn that suffered again from esophageal atresia that was successfully operated on at the same institution by Arnold Coran.

The history of surgical therapy of babies with esophageal atresia after Cameron Haight is a story of success starting with survival rates around 50%, but reaching nearly 100% today when associated life-threatening malformations are excluded. The mainstays of this success are appropriate diagnosis and preoperative therapy, reconstruction of the esophageal continuity with closure of an existing fi stula, or esoph-ageal replacement if necessary.