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 carries air to the lungs.
These defects usually occur together:
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.
If the 2 parts of the esophagus are too far apart, then:
Sometimes the surgeon will wait 2 - 4 months before doing the surgery. Waiting allows your baby to grow or have other problems treated. If your child's surgery is delayed:
Tracheoesophageal fistula and esophageal atresia are life-threatening problems and need treatment right away. If these problems are not treated:
Risks for any anesthesia include:
Risks for any surgery include:
Risks for this surgery are:
Your child will be admitted to the neonatal intensive care unit (NICU) or infant care center (ICC) as soon as the doctors diagnose either of these problems.
Your baby will receive nutrition by vein (intravenous, or IV) and may also be on a breathing machine (ventilator). The nurses may use suction to keep fluids from going into the lungs.
Some infants who have a low birth weight or other birth defects may not be able to have surgery until these other problems have been treated or have gone away.
After surgery, your child will be cared for in a hospital's NICU. Your child will be placed in a special bed called an isolette (incubator), which provides warmth and helps prevent infection.
Additional treatments after surgery usually include:
If both the tracheoesophageal fistula and esophageal atresia are repaired:
If only the tracheoesophageal fistula was repaired and not the esophageal atresia, a gastrostomy tube will be used for feedings until the atresia can be repaired.
How long your infant stays in the hospital will depend on what type of surgery your child needed. You will be able to bring your baby home once he or she is taking feedings by mouth or gastrostomy tube, and is gaining weight.
Surgery can usually repair tracheoesophageal fistula and esophageal atresia. Most children who have had this repair grow up and have normal lives.
Once healing from the surgery is complete, your child may have these problems:
During infancy, some children will have problems with breathing, growth, and feeding, and will need to continue seeing both their primary care provider and specialists.
TEF repair; Esophageal atresia repair
Orenstein S, Peters J, Khan S, Youssef N, Hussain SZ. Congenital anomalies: Esophageal atresia and tracheoesophageal fistula. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 316.
Long JD, Orlando RC. Anatomy, histology, embryology, and developmental anomalies of the esophagus. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2006:chap 40.
Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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