Delayed primary reconstruction of an esophageal atresia with distal esophagotracheal fistula in an infant weighing less than 500 g.

Delayed primary reconstruction of an esophageal atresia (Vogt IIIb) was undertaken in an extremely small-for-date baby (second twin, 36th week) with a birth weight of 445 g. After initial insertion of a gastrostomy under local anesthesia on the 29th day of life, ligation of the fistula and end-to-end anastomosis were performed by transpleural access (weight then, 535 g). There were no complications related to the operative procedure. The baby weighed 1,600 g at the age of 8 months.