Esophageal atresia and tracheoesophageal fistula: a review of 25 years' experience

During a 25-year period (1972-1996), 585 patients with esophageal atresia w ith or without tracheoesophageal fistula were treated at the Department of Pediatric Surgery, SMS Medical College, Jaipur, India. Increasing awareness of the anomaly has led to early detection and referral with fewer pulmonar y complications. For purposes of analysis the period has been divided into live phases, with a steady decline in overall mortality observed from 95.4% in phase 1 to 41% in phase V. Although postoperative complications have al so shown a declining trend, delay in diagnosis, prematurity, low birth weig ht, delayed arrival at the surgical centers, sepsis, pulmonary complication s including pneumonitis, and inadequate nursing care all continue to contri bute substantially to lower the survival in developing countries such as ou rs.