INoEA 2025 7th International Conference on Esophageal Atresia & 11th International PAAFIS Symposium & Aerodigestive Society Meeting

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Poster - 51

Surgical strategies and outcomes in newborns with esophageal atresia and tracheoesophageal fistula associated with duodenal atresia

D Borselle, S Gerus, D Patkowski
Department of Pediatric Surgery and Urology, Medical University and Hospital in Wroclaw, Poland

Introduction: This study aims to review the management and outcomes of esophageal atresia and tracheoesophageal fistula (EA/TEF) associated with duodenal atresia (DA) and to determine the optimal surgical strategy.

Methods: A retrospective analysis was conducted on EA/TEF patients treated between 2005 and 2023 at high-volume center. Demographic data, clinical characteristics, surgical interventions and outcomes were collected and compared.

Results: A total of 11 patients with EA/TEF and accompanying DA were included. All patients presented with type C EA/TEF. Median birth weight was 1850 g. All patients were diagnosed preoperatively with EA/TEF and DA. 2/11 patients had VACTERL association. EA/TEF repair was performed thoracoscopically in all cases. DA repair was performed laparoscopically in 9/11 patients and as open approach in 2/11 newborns. Surgical management strategies included:

  1. One-stage EA/TEF and DA repair in 2/11
  2. A multi-stage approach in 9/11 patients, which involved:
    • Strategy 1: TEF closure and esophageal anastomosis in the first stage, followed by laparoscopic duodenal anastomosis in the second stage (7/11)
    • Strategy 2: TEF closure and open duodenal anastomosis in the first stage, followed by esophageal anastomosis in the second stage (2/11).

Gastrostomy was performed in 2/11 patients: in one later due to feeding difficulties and in another low-birth-weight newborn during the initial surgery to facilitate early enteral feeding. The median interval between stages was 4,5 days. There was no surgery-related mortality. There were no duodenal and esophageal leakage and no need for fundoplication among the analyzed patients

Conclusions: Staged minimally invasive repair appears to be a safe, feasible and preferred surgical strategy for neonates with EA/TEF and associated DA.

Keywords:

D Borselle, S Gerus, D Patkowski
Department of Pediatric Surgery and Urology, Medical University and Hospital in Wroclaw, Poland
Keywords:

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