Oesophageal dilatation for the anastomotic stricture post trachea-oesophageal fistula/oesophageal atresia repair.

Aim of the study: Anastomotic stricture after trachea-oesophageal fistula/oesophageal atresia (TOF/OA) repair is a significant challenge in paediatric surgery. This study investigates the causes, risks, and the need for multiple dilatation procedures.

Method: Data were retrospectively collected from a single centre performing surgeries on babies with TOF/OA from 1998 to 2023.

Results: A total of 47 patients were grouped into AS (with anastomotic strictures, n = 33) and NS (no strictures, n = 14). The median birth weights were 2535 g and 2630 g, respectively. AS group had more premature infants (< 37 weeks, 52 vs 36%). In AS group, four patients had Gross Type A and 1 had Type D; all of NS group had Type C. A long gap between the proximal and distal oesophagus was observed more in AS group (9 vs 1, p < 0.05). Histopathology showed eosinophilic oesophagitis in nine patients from AS group and one from NS group. All patients in AS group underwent dilatation procedures. There were no statistical differences in outcomes related to the frequency of dilatation.

Conclusion: In our study, prematurity, long gap, and oesophagitis increased the possibility of anastomotic stricture. However, these factors did not influence the number of dilatation procedures.