Follow-up of adult patients with repaired esophageal atresia: how, when, and for how long?

Esophageal atresia (EA) is the most common congenital anomaly of the esophagus. With the progress of surgical and anesthetic techniques, the survival is now more than 90% and the majority of children survives and eventually reaches adulthood. However, even if the continuity of the esophagus is anatomically replaced by the surgery, there are some new pieces of evidence that suggest considerable long-term morbidity. In this paper, we will illustrate how symptomatic gastroesophageal reflux, dysphagia, and esophageal motility disturbances, as well as columnar epithelial metaplasia, are common in adults with repaired EA. The ideal follow-up for adult patients born with EA has not been clearly defined, and routine endoscopic assessment has not been widely advocated. It is well known that the patient's symptoms have a poor correlation with histological findings. However, routine follow-up may be expensive and time consuming. With the growing number of children reaching adulthood, it is now essential to know and understand the natural history of this condition to improve the management of these patients.