Esophageal atresia (T-E fistula): an index for neonatal surgery.

During the period 1978-1990 (12.5 years), 929 neonatal general surgical emergencies were treated at the Seoul National University Children's Hospital. There were 308 anorectal malformations, 128 atresia/stenosis of the gut, 125 neonatal Hirschsprung's disease, 75 gastroschisis and 67 esophageal atresias. The highest operative mortality rate of 26.9% was experienced in esophageal atresia with or without tracheo-esophageal atresia. Problems in respiratory care and surgical technical failure were the main causes of failure. Esophageal atresia can be used as an index for the status of neonatal surgical care since analysis of mortality of other operations indicates a similar but less exaggerated pattern.