Diagnosis and treatment of gastroesophageal reflux in patients with esophageal atresia

In the last two decades, surgical treatment of children born with esophageal atresia has become a standard procedure. Postoperative mortality- now negligible in those born at term without other severe anomalies- mainly relates to patients with associated severe congenital cardiac malformations, cerebral and pulmonary complications, or chromosomal abnormalities incompatible with life. Extreme prematurity may be a causative factor for mortality as well. Mortality in affected premature infants has considerably decreased, however, owing to advances in medical care. In the light of this development, professional attention now focuses on postoperative morbidity. 18•39.47 Most attention goes out to gastroesophageal reflux and its long-term sequelae, the relationship with healing of the anastomosis, recurrent respiratory tract infections, tracheomalacia, and delayed growth and development. While well-standardized diagnostic procedures and treatment plans have been established for otherwise unaffected infants with reflux disease, these are not yet available for patients showing reflux after repair of esophageal atresia.