Prophylactic extrapleural chest drainage following repair of esophageal atresia: is it necessary?

In a review of 110 cases of esophageal atresia (EA) and tracheoesophageal fistula (TEF), 15 patients (13.6%) developed anastomotic leakage. All patients had extrapleural surgical exposure and prophylactic extrapleural chest drainage (PEPCD). Despite this precaution, all patients with anastomotic leaks developed a pneumothorax with or without a pleural effusion. This required insertion of an additional drain in 12 (80%) cases. PEPCD following repair of EA and TEF does not appear to prevent pneumothorax or pleural effusion when anastomotic leakage occurs.