Short-term complications

A number of complications may occur fairly soon after the initial esophageal atresia (EA) repair.

Anastamotic Leak

After the ends of the esophagus are re-connected (this is called an anastamosis), the area may leak. This happens in about 17% of surgeries. Saliva, other fluids, or air can leak into the chest as a result. This is normally removed with a chest tube – a tube placed between the ribs that ends between the inside of the chest wall and the outside of the lungs. 95% of the time, these leaks seal on their own. The rest of the time, surgery may be needed to close the leak. However, infants who’ve had an anastomatic leak are more prone to have an esophageal stricture or a recurrent TEF.

Nerve Problems

Several important nerves travel near the trachea and esophagus, which, rarely, are damaged during surgery. One is a nerve that goes to the vocal cords. Damage to this nerve can cause paralysis of one of the vocal cords, which can impair speech and increase the risk of aspiration of saliva. Another nerve, called the phrenic nerve, is needed to move the diaphragm. Damage to the right phrenic nerve can cause paralysis of one of the diaphragms, and difficulty breathing.

Tom Kovesi MD, Pediatric Respirologist, Children’s Hospital of Eastern Ontario, Ottawa, Ontario Canada