GASTRIC TUBE AS THE PRIMARY PROCEDURE FOR PURE ESOPHAGEAL ATRESIA

Long gap esophageal atresia occurs in approximately 5% of patients wit h tracheoesophageal anomalies. A small group of such patients have a r udimentary or diverticular distal esophagus that is not amenable to pr imary repair. These children usually require staged procedures and eso phageal replacement using other parts of the intestinal tract. To circ umvent the morbidity and delayed repair associated with cervical esoph agostomy, colon interposition, or delayed gastric tube interposition, the authors propose the use of a primary gastric tube for early establ ishment of esophageal continuity in the neonate. Three cases of early esophageal replacement using a gastric tube are described. All three p atients were born prematurely, with comorbid conditions, and had a rud imentary distal esophagus. The results of the operation were successfu l. The authors believe that primary repair of the esophagus, when poss ible, is the gold standard. Copyright (C) 1996 by W.B. Saunders Compan y