FACTORS CONTRIBUTING TO POOR RESULTS OF TREATMENT - OF ESOPHAGEAL ATRESIA IN DEVELOPING-COUNTRIES

The results of treatment of 342 consecutive cases of esophageal atresi a/tracheoesophageal fistula over an 11-year period have been analyzed to determine the factors resulting in a poorer prognosis of these case s in a developing country; 121 neonates in the first 6-year period are compared with 220 in the last 5 years. In the latter group only 8% we re in Waterston's group A; 46% reached the hospital within 24 h of bir th, 13% were normothermic on presentation, 70% had a chest infection, and 28% had major associated malformations. This was similar to the pr eceding 6-year period. In the last 5 years the overall mortality was 5 8%, compared to 67% in the preceding 6 years. Despite improvement in s urvival in the last 5 years, the overall survival is far inferior to t hat reported from the developed countries. The factors resulting in po orer results have been analyzed and remedial actions suggested.