The value of circular myotomy for esophageal atresia.

The joining of widely separated proximal and distal esophageal segments in esophageal atresia remains a challenging problem. Livaditis introduced the operation of circular myotomy as an effective means of bridging such a wide gap. Three babies with esophageal atresia were successfully treated in this manner at the Hospital for Sick Children, Toronto, during the 1st 6 mo of 1976. No alterations in blood supply of the upper esophageal pouch were observed, and elongations of at least 1 cm per myotomy were obtained. No unusual postoperative radiographic observations were noted. Our small clinical experience suggests that circular myotomies aid in reducing long esophageal gaps in some infants with esophageal atresia, thus permitting primary esophageal anastomosis.