Esophageal Atresia Repair
What is Esophageal Atresia Repair ?
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Why do you need Esophageal Atresia Repair ?
EA repair is indicated for:
- Esophageal Atresia (EA) with or without Tracheoesophageal Fistula (TEF):
- EA: The esophagus ends in a blind pouch, not connecting to the stomach (1 in 2,500–4,000 births).
- TEF: Abnormal connection between esophagus and trachea (90% of EA cases, most common type: proximal EA with distal TEF).
- Symptoms: Excessive drooling, choking/coughing during feeding, cyanosis, or inability to pass a feeding tube into the stomach.
- Associated conditions:
- Part of VACTERL association (30–50% of cases): Vertebral, Anorectal, Cardiac, TEF, Renal, Limb anomalies.
- Timing:
- Surgery typically within 24–48 hours of birth, after stabilization, unless prematurity or severe comorbidities delay it.
The procedure aims to connect the esophagus, close any fistula, enable normal feeding, and prevent aspiration, often requiring intensive neonatal care.
Why Do Esophageal Atresia Repair Costs Vary in Philippines?
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Esophageal Atresia Repair Procedure
- Before Surgery Evaluation:
- Diagnosis:
- Prenatal ultrasound: May detect polyhydramnios (excess amniotic fluid) or absent stomach bubble.
- Postnatal X-ray: Shows feeding tube coiled in upper pouch; air in stomach indicates TEF.
- Echocardiogram: Assesses heart defects (e.g., VSD, 20–30% of cases).
- Blood tests: Arterial blood gas (ABG) to monitor oxygenation.
- Stabilization: Suction upper pouch to prevent aspiration; IV fluids; ventilator if needed.
- Consent: Risks, including leakage, are explained.
- Diagnosis:
- Surgical Techniques:
- EA/TEF Repair:
- Performed under general anesthesia, lasting 2–4 hours.
- Approach:
- Open surgery: Right thoracotomy (chest incision, 5–8 cm), most common in India.
- Thoracoscopic: Minimally invasive (small incisions, camera-guided); used in stable infants at advanced centers.
- Repair:
- TEF ligation: Fistula between esophagus and trachea closed with sutures.
- Esophageal anastomosis: Upper and lower esophageal segments connected with sutures.
- If gap too large (long-gap EA, 10–15% of cases): May need staged repair (e.g., Foker process, stretching esophagus over weeks) or esophageal replacement (using stomach/colon, rare).
- Chest tube: Placed to drain fluid/air and support lung expansion.
- Intraoperative Tools:
- Endoscope (if thoracoscopic): Visualizes anatomy.
- Fine sutures: Closes fistula and joins esophagus.
- Ventilator: Supports breathing during surgery.
- EA/TEF Repair:
- After Surgery:
- Hospital stay: 2–6 weeks (NICU).
- Care: Mechanical ventilation (days to weeks), feeding via gastrostomy tube (G-tube) or total parenteral nutrition (TPN) initially.
- Pain management: Moderate pain for 3–7 days; managed with IV analgesics (e.g., fentanyl).
- Instructions: Monitor for respiratory distress; gradual introduction of oral feeding.
Recovery After Esophageal Atresia Repair
- Hospital Stay: 2–6 weeks (NICU).
- Post-Surgery Care:
- Ventilation: Often required for 3–14 days, depending on lung function.
- Feeding: TPN or G-tube for 1–3 weeks; oral feeding starts once anastomosis heals (2–4 weeks, confirmed by esophagogram).
- Pain/Swelling: Moderate pain for 3–7 days; incision swelling resolves in 1–2 weeks.
- Breathing: Improves as lungs adapt; some need oxygen support longer.
- Activity: Normal infant activities once off ventilator; avoid pressure on chest.
- Follow-Up:
- Visits at 1 month, 3 months, and 6 months.
- Esophagogram: At 2–4 weeks to check for leaks or narrowing.
- Developmental assessment: At 6–12 months for milestones (e.g., feeding, growth).
Full recovery varies; most leave NICU in 3–6 weeks, but feeding and growth challenges may persist. Survival rate: 85–95% with modern care; long-term outcomes depend on associated anomalies and complications.
Risks and Complications
- Surgical Risks:
- Bleeding (2–5%): Intra-thoracic bleeding; may need transfusion.
- Infection (3–5%): At incision site or lungs (pneumonia); treated with antibiotics.
- Anesthesia risks (<1%): Reaction to general anesthesia; rare in stable infants.
- Post-Surgery:
- Anastomotic leak (5–15%): Leak at esophageal connection; may heal with drainage or need reoperation.
- Stricture (10–20%): Narrowing at repair site; may need dilation (1–3 sessions).
- Recurrent TEF (3–5%): Fistula reopens; needs surgical closure.
- Tracheomalacia (10–20%): Weak trachea causing breathing issues; may improve with time.
- Long-Term:
- Gastroesophageal reflux (GERD, 40–60%): Common in EA; managed with medication or surgery (e.g., fundoplication).
- Dysphagia (10–30%): Difficulty swallowing; needs feeding therapy.
- Growth delays (10–20%): Due to feeding issues; needs nutritional support.
Report respiratory distress, fever, vomiting, or poor feeding promptly.
Frequently Asked Questions (FAQs)
What causes esophageal atresia?
Unknown; likely genetic and environmental factors; part of VACTERL association in 30–50% of cases.
Can I avoid EA repair?
No, surgery is necessary to enable feeding and prevent aspiration; non-surgical care only stabilizes pre-surgery.
Is EA repair painful?
Moderate pain for 3–7 days, managed with IV analgesics; infants recover with proper care.
How soon can my child resume normal feeding?
Oral feeding: 2–4 weeks (after healing confirmed); normal feeding patterns may take months.
Is EA repair covered by insurance in India?
Yes, for congenital defects; confirm with your provider; Ayushman Bharat often subsidizes.
Signs of complications?
Respiratory distress, fever, vomiting, or poor feeding.
Will my child have normal feeding and growth?
85–95% survive; feeding improves with time, but GERD and growth challenges are common—needs ongoing care.
Lifestyle changes post-surgery?
Monitor feeding, manage GERD, attend follow-ups (growth, development), and avoid respiratory infections.
Conclusion
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Looking for Best Hospitals for Esophageal Atresia Repair
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.