Analysis and management of anastomotic strictures after esophageal atresia repair

Objective To identify the risk factors of anastomotic strictures （AS ） after esophageal atresia （EA）repair and explore the efficacies of esophageal dilatations for AS.Methods Retrospective analyses were performed for the data of 155 EA patients with trachoesophageal fistula （Gross type Ⅲ）patients undergoing esophageal anastomosis at our institution between January 1994 and December 2013.Results A total of 17 cases developed AS （type A,n=4;type B,n=13）.The AS rate was 1 1 .0% and anastomotic leak rate 36.1%.By chi-square test,the difference of those with anastomotic stricture with or without leakage was statistically significant.No statistical differences existed in anastomotic leak or stricture between different classifications.Sixty-three dilation sessions were performed with an average of 3.71 （1-10）sessions per patient.Conclusions The distance between proximal blind pouch and distal fistula has no correlation with an elevated risk of AS.Patients of an anastomotic leak have an elevated risk of developing AS （P=0.009）.Stricture may be managed by subsequent esophageal dilatations. Key words: Esophageal atresia Dilatation Anastomotic stricture