IMPROVEMENT in surgical techniqus and in the management of postoperative problems encountered in the usual varieties of esophageal atresia during the past decade has resulted in a striking increase in the survival rate among these infants. This has led to renewed interest in the less common anatomic types and in the unusual clinical situations where, in contrast, the mortality remains high. These include infants with overwhelming pneumonias, prematurity, complicating associated anomalies, and the "uncommon" varieties, types A, B, D, and E (Gross).1 Several changes in therapeutic policy and technical innovations directed at the solution of problems raised by these special groups are presented.
Delayed Primary Anastomosis
These postponements of primary anastomosis fall into two distinct groups: (a) relatively short "delays" for acute conditions, in which the deferment is confined to a maximum of ten days to two weeks; and (b) longer delays which are designed to permit growth, elongation