• Yuichi Okata, Kosaku Maeda, Yuko Bitoh, Yasuhiko Mishima, Akihiko Tamaki, Keiichi Morita, Kosuke Endo, Chieko Hisamatsu, Hiroaki Fukuzawa, and Akiko Yokoi.
• Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7, Minatojimaminami-chou, Chuo-ku, Kobe, 654-0081, Japan. yuichi.okata@gmail.com.
• Pediatr. Surg. Int. 2016 Sep 1; 32 (9): 869-73.

PurposeThe aim of this study is to identify the risk factors for esophageal anastomotic stricture (EAS) and/or anastomotic leakage (EAL) after primary repair of esophageal atresia with tracheoesophageal fistula (EA/TEF) in infants.MethodsA retrospective chart review of 52 patients with congenital EA/TEF between January 2000 and December 2015 was conducted. Univariate and multivariate analyses were performed to identify the risk factors for anastomotic complications.ResultsTwenty-four patients were excluded from the analysis because they had insufficient data, trisomy 18 syndrome, delayed anastomosis, or multi-staged operations; the remaining 28 were included. Twelve patients (42.9 %) had anastomotic complications. EAS occurred in 12 patients (42.9 %), and one of them had EAL (3.57 %). There was no correlation between anastomotic complications and birth weight, gestational weeks, sex, the presence of an associated anomaly, age at the time of repair, gap between the upper pouch and lower pouch of the esophagus, number of sutures, blood loss, and gastroesophageal reflux. Anastomosis under tension and tracheomalacia were identified as risk factors for anastomotic complications (odds ratio 15, 95 % confidence interval (CI) 1.53-390.0 and odds ratio 8, 95 % CI 1.33-71.2, respectively).ConclusionSurgeons should carefully perform anastomosis under less tension to prevent anastomotic complications in the primary repair of EA/TEF.

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