Skip to main content
Log in

Long-term evaluation of esophageal and pulmonary function in patients with repaired esophageal atresia and tracheoesophageal fistula

  • Original Articles
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Patients who have undergone repair of esophageal atresia and tracehoesophageal fistula as infants have been noted to have residual esophageal dysmotility and pulmonary dysfunction during their childhood years. However, limited information is available about the long-term follow-up of these patients. In this study we performed esophageal and pulmonary function studies on 12 adults who had required surgical repair of these defects in the first week of life. Most patients had symptoms of dysphagia and heartburn at time of evaluation. Pathologic gastroesophageal reflux was documented in 67% of patients and esophagitis was noted in 34%. All patients had esophageal motility abnormalities characterized by low-amplitude nonperistaltic waves throughout most of the esophagus. In addition, although most patients had no respiratory symptoms, mild restrictive lung volumes were noted in many patients. However, airflow obstruction and airway hyperreactivity were not present. These data demonstrate that clinical symptoms and abnormal esophageal manometry and pulmonary function persist well into the third and beginning of the fourth decade after repair of esophageal atresia and tracheoesophageal fistula in infancy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Haight C, Towsley HA: Congenital atresia of the esophagus and tracheoesophageal fistula: Extrapleural ligation of fistula and end to end anastomosis of esophageal segments. Surg Gynecol Obstet 76:672, 1943

    Google Scholar 

  2. Wooley M: Esophageal atresia and tracheoesophageal fistula: 1939–1979. Am J of Surg 139:771–774, 1980

    Google Scholar 

  3. Whitington PF, Shermeta DW, Seto DSY, Jones L, Hendrix TR: Role of lower esophageal sphincter incompetence in recurrent pneumonia after repair of esophageal atresia. J Pediatr 91:550–554, 1977

    Google Scholar 

  4. Orringer M, Kirsh M, Sloan H: Long-term esophageal function following repair of esophageal atresia. Ann Surg 186:436–443, 1977

    Google Scholar 

  5. Werlin S, Dodds W, Hogan W, Glicklich M, Arndurfer R: Esophageal function in esophageal atresia. Dig Dis Sci 26:796–800, 1981

    Google Scholar 

  6. Parker AF, Christie DL, Cahill JL. Incidence and significance of gastroesophageal reflux following repair of esophageal atresia and tracheoesophageal fistula and the need for antireflux procedures. J Pediatr Surg 14:5–8, 1979

    Google Scholar 

  7. Lind JF, Blanchard JR, Guyda H: Esophageal motility in tracheoesophageal fistula and esophageal atresia. Surg Gynecol Obstet 123:557–564, 1987

    Google Scholar 

  8. Laks H, Wilkinson R, Schuster S: Long-term results following correction of esophageal atresia with tracheoesophageal fistula: A clinical and cinefluorographic study. J Pediatr Surg 7:591–597, 1972

    Google Scholar 

  9. Milligan D, Levison H: Lung function in children following repair of tracheoesophageal fistula. J Pediatr 95:24–27, 1979

    Google Scholar 

  10. Dudley NE, Phelan PD: Respiratory complications in longterm survivors of oesophageal atresia. Arch Dis Child 51: 279–282, 1976

    Google Scholar 

  11. Boix-Ochoa J, Lafuente J, Gil-Vernet J: Twenty-four hour esophageal pH monitoring in gastroesophageal reflux. J Pediatr Surg 15:74–78, 1980

    Google Scholar 

  12. Johnson L, Demeester T: Twenty-four hour pH monitoring fo the distal esophagus. Am J Gastroenterol 62:32:332–336, 1974

    Google Scholar 

  13. Heyman S, Kirkpatrick J, Winter H, Treves S: An improved radionuclide method for the diagnosis of gastroesophageal reflux and aspiration in children (milk scan). Radiology 131:479–482, 1979

    Google Scholar 

  14. Treves ST (ed): Pediatric Nuclear Medicine. New York, Springer Verlag, 1985

    Google Scholar 

  15. Winter H, Madara J, Stafford R, Grond R, Quinlan J, Goldman H: Intraepithelial esophagitis: A new diagnostic criterion for reflux esophagitis. Gastroenterology 83:818–823, 1982

    Google Scholar 

  16. Cook C, Hamman J: Relationship of lung volumes to height in healthy persons between the ages of 5 and 38 years. J Pediatr 59:710–714, 1961

    Google Scholar 

  17. Knudson RJ, Lebowitz MD, Holberg CJ, Burrows, B: Changes in the normal maximal expiratory flow volume curve with growth and aging. Am Rev Respir Dis 127:725–734, 1983

    Google Scholar 

  18. McLaughlin FJ, Dozor AJ: Cold air inhalation challenge in the diagnosis of asthma in children. Pediatrics 72:503–509, 1983

    Google Scholar 

  19. Tal A, Pasterkamp H, Serette C, Leahy F, Chernick V: Response to cold air hyperventilation in normal and in asthmatic children. J Pediatr 104:516–521, 1984

    Google Scholar 

  20. O'Cain CF, Dowling NB, Slutsky AS, Hensley MJ, Strohl KP, McFadden ER, Ingram RH Jr: Airway effects of respiratory heat loss in normal subjects. J Appl Physiol: Respir Environ Exercise Physiol. 49:875–880, 1980

    Google Scholar 

  21. Humphries TJ, Castell DO: Pressure profile of esophageal peristalsis in normal humans as measured by duct intraesophageal transducers. Am J Dig Dis 22:641–645, 1977

    Google Scholar 

  22. Goyal R, Cobb B: Motility of the pharynx, esophagus and esophageal sphincters.In Physiology of the Gastrointestinal Tract. Leonard Johnson, (ed). New York, Raven Press, 1981, pp 359–391

    Google Scholar 

  23. Duranceau A, Fisher S, Flye MW, Jones R S, Postlethwait RW, Sealy WC: Motor function of the esophagus after repair of esophageal atresia and tracheoesophageal fistula. Surgery 82:116–123, 1977

    Google Scholar 

  24. Couriel JM, Hilbert M, Olinsky A, Phelan PD: Long-term pulmonary consequences of esophageal atresia with tracheoesophageal fistula. Acta Pediatr Scand 71:973–978, 1982

    Google Scholar 

  25. Pearson JEG, Wilson RE: Diffuse pulmonary fibrosis and hiatus hernia. Thorax 26:300–305, 1971

    Google Scholar 

  26. Mays EE, Dubois JJ, Hamilton GB: Pulmonary fibrosis associated with tracheobronchial aspiration: A study of the frequency of hiatal hernia and gastroesophageal reflux in interstitial pulmonary fibrosis of obscure etiology. Chest 69:512–515, 1976

    Google Scholar 

  27. Boyle JT, Tuchman DN, Altschuler SM, Nixon TE, Pack AI, Cohen S: Mechanisms for the association of gastroesophageal reflux and bronchospasm. Supplement: Aspiration Hazards to the Developing Lung. Am Rev Respir Dis 131:s16-s20, 1985

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Supported in part by Pediatric Gastroenterology Research Training Grant AM07471 (J.A.B.) and AM07477 (H.S.W.) and the Parker B. Francis Foundation (J.L.A.). During the early stages of the study Dr. Biller was the recipient of a clinical training award from the Cystic Fibrosis Foundation.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Biller, J.A., Allen, J.L., Schuster, S.R. et al. Long-term evaluation of esophageal and pulmonary function in patients with repaired esophageal atresia and tracheoesophageal fistula. Digest Dis Sci 32, 985–990 (1987). https://doi.org/10.1007/BF01297188

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01297188

Key Words

Navigation