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Esophageal Strictures After Anastomosis in Esophageal Atresia

Arch Surg. 1963;87(1):120-124. doi:10.1001/archsurg.1963.01310130122016.
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Congenital atresia of the esophagus occurs once in every 3,000 births.1 In approximately 90% of these anomalous infants the upper esophageal segment terminates blindly and the lower segment forms a fistula into the trachea at or near the carina. Division of the fistula and end-to-end anastomosis of the esophagus is the treatment of choice. With prompt surgical treatment, the survival rate has steadily increased since the first successful case was reported by Haight and Towsley.2 A collected series of 967 patients reported from 11 separate institutions since 1956 yields a mean operative survival rate of 52%.3

The commonest complication in the infants who survive esophageal anastomosis is stricture formation. Gross,4 Swenson,5 Holinger,6 and, more recently, Morrison7 have noted that significant difficulty due to postanastomotic stricture was observed in 35% to 50% of their patients. Although dysfunctional swallowing may mimic stricture, for the purpose of


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