Our Experience of Anesthesia in Newborn with Tracheoesophageal Fistula/Esophageal Atresia: A Retrospective Analysis of 65 Cases

Abstract

Objective: Follow-up of newborns with tracheoesophageal fistu­la (TEF) and esophageal atresia (EA) requires special attention and care from the moment they are born. Anesthesiologists have to deal with several problems, that may develop instantly, during perioperative management of these patients. Complications and mortality increase especially in cases where the vital and metabolic parameters that determine the prognosis of the patients are not well managed. In this retrospective study, our aim is to present the anesthesia management of 65 patients who were followed up and treated in our clinic, with sufficient perioperative data records, and the results obtained in the light of current literature. Methods: In this study, the perioperative management of 65 patients who underwent EA and TEF surgery between 2010-2021 in the Erciyes University Faculty of Medicine Pediatric Surgery operating room were retrospectively analyzed. Results: Of the 65 cases evaluated, 34 were male and 31 were female. The time of admission to surgery was determined as the 4th day after birth in those who underwent thoracoscopic surgery and the 5th day in those who underwent open surgery. Forty-three patients had cardiac anomalies. The surgical approach was usually performed with thoracotomy (72%). Patients who underwent thoracoscopic surgery had shorter intubated and hospitalization times in the intensive care unit. In those who were operated with thoracotomy, oral feeding was started later than thoracoscopic surgery. Conclusion: The inclusion of cases with open and thoracoscopic surgical corrections in our study and the application of the institutional anesthesia protocol accepted in our clinic in the perioperative management of all cases increase the reliability of our results. In this study, the experience of the authors on perioperative anesthesia management of TEF/EA patients who will undergo surgical correction by open or thoracoscopic method is presented and discussed together with the literature information. Keywords: Tracheoesophageal fistula, esophageal atresia, thoracotomy, thoracoscopy