Congenital Tracheoesophageal Fistula with or without Esophageal Atresia, King Abdulaziz University Hospital Experience over 15 Years

The aim is to study the profile of congenital tracheoesophageal fistula with or without esophageal atresia with the effect of modalities of surgical and postoperative management on their outcome. Retrospective study of the records of all cases that had been diagnosed as congenital tracheoesophageal fistula with or without esophageal atresia treated at King Abdulaziz University Hospital, between 1992 and 2007 inclusive were reviewed. A total of 48 neonates were studied. Forty-three cases (72.8%) had esophageal atresia with distal fistula: ten cases were pure esophageal atresia; one case had esophageal atresia with proximal and distal fistulae. Four cases had H-type of tracheoesophageal fistula. On applying the Waterston prognostic classification to all patients, the survival rate was 94.5%, 76.2% and 22.2% for classes A, B and C, respectively. Incidence of esophageal congenital anomalies in KAUH was 1:3574 life births, with male: female ratio 3:2. The overall mortality rate was 25%, whereas the mortality rate among operated cases was 20%. Seven cases developed stricture (15.5%) and 5 had anastomotic leaks (11.1%).