Long term results following esophageal anastomosis in the neonate.

In this series, a striking decrease in stricture formation following one layer repair of the esophagus in the newborn with esophageal atresia is clearly demonstrated. The long term evaluation of repair of esophageal atresia in the neonate shows a significant association between morbidity and the presence of a stricture. Long term sequelae related to anastomotic leaks were not evident. A close association between a leak and subsequent stricture formation has been suggested, but that relationship is not substantiated by this review. The number of deaths from anastomotic complications is too small to allow a valid comparison, but the mortality for the two anastomotic groups appears comparable. There is also no significant difference in mortality associated with the type of anastomotic complication. On the basis of these results, we suggest that repair of esophageal atresia in the neonate be done using a one layer end-to-end anastomosis through an extrapleural approach with good drainage.