LATE PULMONARY-FUNCTION FOLLOWING REPAIR OF TRACHEOESOPHAGEAL FISTULAOR ESOPHAGEAL ATRESIA

Although tracheoesophageal fistula and esophageal atresia (TEF-EA) are surgically correctable, late respiratory complications have been repo rted. We administered a respiratory and gastrointestinal symptom quest ionnaire and performed standard pulmonary function tests (PFT's) and m ethacholine challenge testing on an unselected group of 25 subjects wi th TEF-EA who underwent surgery at our institution between 1963 and 19 85. Results were compared to predicted normals, as well as 10 sibling controls. While the mean values of lung function test results for the TEF-EA group were within the normal range, they were significantly dif ferent from their siblings. Thirteen of the 25 TEF-EA group (52%), but none (0%) of the controls, had abnormal pulmonary function. This was classified as restrictive in 9 (36%), obstructive in 3 (12%), and mixe d in 1. In addition, airway hyperreactivity [defined as a positive met hacholine challenge (PC20 less than or equal to 8 mg/mL)], was found i n 6 of 18 TEF-EA subjects and 4 of the 9 controls who were evaluated. Comparison of TEF-EA subjects with normal and abnormal PFTs showed no difference in the incidence of tracheomalacia, esophageal strictures o r dilatation, recurrent pneumonias, or gastroesophageal reflux. The re spiratory symptom score in the subjects and controls was similar, and did not correlate with abnormal pulmonary function. The cause of the p ulmonary function abnormalities remains unexplained. (C) 1995 Wiley-Li ss, Inc.