Tracheoesophageal fistula and esophageal atresia repair

Definition

Tracheoesophageal fistula and esophageal atresia repair is surgery to repair two birth defects in your esophagus and trachea. Your esophagus is the tube that carries food from the mouth to the stomach. Your trachea, or windpipe, is the tube that normally air to the lungs.

These defects usually occur together:

• Esophageal atresia is when the upper part of the esophagus does not connect with the lower esophagus and stomach.
• Tracheoesophageal fistula (TEF) is when the upper part of the esophagus connects to the trachea or windpipe, instead of to the lower esophagus and stomach.

Alternative Names

TEF repair; Esophageal atresia repair

Description

This surgery is almost always done soon after birth. Surgery is done while the child is in a deep sleep and pain-free from general anesthesia.

Tracheoesophageal fistula and esophageal atresia can usually be repaired at the same time.

• The surgeon will make a cut on the right side of the chest between the ribs.
• The fistula, which is the abnormal connection between the esophagus and windpipe, is closed off.
• Then the upper and lower portions of the esophagus are sewn together.

If the 2 parts of the esophagus are too far apart, then:

• Only the fistula will be repaired during the first surgery.
• A gastrostomy tube (a tube that goes through the skin into the stomach (also called a g-tube) may be placed to give your child nutrition.
• Your child will have another surgery later to repair the esophagus.

Sometimes the surgeon will want to wait 2 to 4 months before doing the surgery. Waiting a little allows your baby to grow or have other problems treated. If your child's surgery is delayed:

• A gastrostomy tube will be placed. The gastrostomy tube is often placed using numbing medicines (local anesthesia) so that your baby does not feel pain.
• During this time, the doctor may want to widen your baby's esophagus with a special instrument called a dilator. This will make the future surgery easier.

Risks

Risks for any anesthesia include:

• Reactions to medicines
• Breathing problems

Risks for any surgery include:

• Bleeding
• Infection

Risks for this surgery are:

• Narrowing of the repaired organs
• Food leakage from the area that is repaired
• Re-opening of the fistula
• Collapsed lung (pneumothorax)
• Hypothermia (low body temperature)