Tracheoesophageal fistula and esophageal atresia repair is surgery to repair two birth defects in the esophagus and trachea.
The esophagus is the tube that carries food from the mouth to the stomach. The trachea, or windpipe, is the tube that carries air into and out of the lungs.
These defects usually occur together:
This surgery is almost always done soon after birth. Both defects can usually be repaired at the same time. Briefly, the surgery takes place this way:
If the two parts of the esophagus are too far apart, then:
Sometimes the surgeon will wait 2 to 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. They need to be treated right away. If these problems are not treated:
Risks of anesthesia include:
Risks of surgery include:
Your baby will be admitted to the neonatal intensive care unit (NICU) 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 are premature, have a low birth weight, or have other birth defects beside TEF and/or EA 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 the hospital's NICU. Your child will be placed in a special bed called an incubator, which provides warmth and helps prevent infection.
Additional treatments after surgery usually include:
If both the TEF and EA are repaired:
If only the TEF is repaired, a gastrostomy tube is used for feedings until the atresia can be repaired.
While your baby is in the hospital, the nurses will show you how to use and replace the gastrostomy tube. You will also be sent home with an extra gastrostomy tube. The nurses will inform a home health supply company of your equipment needs.
How long your infant stays in the hospital depends on the type of surgery your child has. 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 a TEF and EA. Once healing from the surgery is complete, your child may have these problems:
During infancy and early childhood, many 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
Khan S, Orenstein SR. Congenital anomalies. In: Kliegman RM, Stanton BF, St. Geme JW III, et al., eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 311.
Song C, Upperman JS, Niklas V. Structural anomalies of the gastrointestinal tract. In: Gleason CA, Devaskar SU, eds. Avery's Diseases of the Newborn. 9th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 69.
Updated by: Kimberly G. Lee, MD, MSc, IBCLC, Associate Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 1997-2015, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing by ADAM Health Solutions.