Cure of esophageal atresia types 1 and 2. Deferred primary anastomosis. Apropos of 6 cases

From 1976 to 1981 six patients with esophageal atresia types 1 and 2 underwent a successful delayed primary anastomosis. At birth a gap between the upper and lower pouch (5 to 7 vertebras) was present. 9 to 14 weeks later, at surgery, the mean gap was 3 vertebras and the anastomosis was carried out without excessive tension. No upper pouch elongation was done before surgery and end-to-end esophageal anastomosis was accomplished without the need of circular myotomy. All patients are alive and well after a follow up period from 6 months to 6 years. We have to mention post-operative complications; 3 anastomotic extrapleural leaks were managed conservatively by peripheric parenteral nutrition, 1 post operative tracheo-esophageal fistula required a closure and 2 patients with a symptomatic gastro-esophageal reflux were managed by antireflux fundoplication. No anastomotic stricture was observed. The functional results are excellent.