ABSTRACT
Surgery for esophageal atresia (EA) is widely regarded as one
of the most notable success stories in newborn surgery.
Advances in neonatal intensive care have now led to greater
than 95% survival for many babies treated in the modern era
with increasing attention now focusing on morbidity, long-
term clinical outcomes, and quality of life (QoL) in adult
survivors. Recent noteworthy developments in EA manage-
ment include minimally invasive thoracoscopic surgery and
the deployment of the axillary skin crease thoracotomy
pioneered by Bianchi. Expert opinion controversially dom-
inates best practice with regard to pure long-gap esophageal
atresia without fistula, medical versus surgical treatment of
gastro-esophageal reflux (GER) disease, therapies for anasto-
motic stricture, and tracheomalacia. Applied embryology and
molecular genetic studies continue to yield fascinating back-
ground into the etiology of EA and tracheo-esophageal fistula
(TEF), with insightful contributions emerging from animal
models sharing striking similarity to the human phenotype.2,3
The history of EA and TEF is well described in the literature.2,3
The first survivors were not recorded until 1939 with Leven
and Ladd achieving success with staged esophageal repair.
Cameron Haight (an American surgeon working at Ann
Arbor, Michigan) is fully credited with the first successful
primary repair and survival of a 12-day-old female neonate.
Reports from the UK soon followed with Franklin (1947) at
the Hammersmith Hospital, London, Sir Denis Browne (1948)
at Great Ormond Street Hospital, London, and Peter Paul
Rickham (1949) at Alder Hey Children’s Hospital in Liverpool
