TY - CHAP M1 - Book, Section TI - Esophageal Atresia A1 - Coppi, Paolo De A1 - Pierro, Agostino A2 - Ziegler, Moritz M. A2 - Azizkhan, Richard G. A2 - Allmen, Daniel von A2 - Weber, Thomas R. PY - 2014 T2 - Operative Pediatric Surgery, 2e AB - Most cases of esophageal atresia and tracheoesophageal fistula (EA/TEF) occur sporadically. In 50% to 80% of cases, there are associated anomalies, most frequently musculoskeletal malformations, followed by cardiovascular, genitourinary, gastrointestinal, and chromosomal anomalies.Unlike other congenital malformations, EA is infrequently diagnosed prenatally.Polyhydramnios is present in 95% of patients with isolated EA without TEF, and in 35% of cases with distal TEF.All infants with EA should have an echocardiogram before operative repair because of the high incidence of congenital cardiac anomalies.In neonates with EA/TEF, the diagnosis can be confirmed by tracheobronchoscopy and/or esophagoscopy.Surgical repair should be done soon after birth. It is not an emergency procedure, but neonates requiring mechanical ventilation should be operated on promptly to avoid gastric distension and possible perforation.Physiological stable neonates with EA and TEF can be managed with a single operation to divide the distal fistula and perform the esophageal anastomosis.In 10% of neonates with EA and TEF who are very premature or physiological unstable, ligation of the TEF is performed first and the esophageal anastomosis is done as a secondary stage repair when the baby is stable.Thoracoscopic repair offers a scarless repair with faster recovery and less postoperative pain and may also potentially protect from later problems such as winged scapula and thoracic asymmetry. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/12/08 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1100433096 ER -