Esophageal atresia with tracheoesophageal fistula: end-to-end versus end-to-side repair.

Despite early enthusiasm by some authors for the end-to-side repair of esophageal atresia with tracheoesophageal fistula, many have returned to the end-to-end technique. The present study compares the results of these two operative procedures. A retrospective analysis was made of 52 consecutive cases in which primary repair was performed. The patients were divided according to the three preoperative risk groups descibed by Waterston. The mortality for the end-to-end and end-to-side repairs was similar in each of the three risk groups. Similarly, there was no significant differnences in the incidence of anastomotic leak or recanalization of the fistula. However, the rate of anastomotic stricture in the end-to-end group was significantly higher (p less than 0.001) than in the end-to-side group. A description of the end-to-side technique is given, and its advantages are outlined.