[Esophageal atresia and gastro-esophageal reflux].

Gastro-esophageal reflux has been noted in 60% out of 113 cases of esophageal atresia treated successfully at the Hôpital Saint-Vincent-de-Paul, between the years 1970 and 1978. The tolerance of the reflux in these 58 cases has been variable : 13 children developed severe respiratory complications; 17 children had a stricture at the anastomosis site. Although the general outcome for this type of reflux should be favorable, either spontaneously or by medical means, surgical treatment, usually by fundoplication occasionally may be indicated; 15 children were operated. One died from reflux complications before the operation could be planned. It is possible that the severity of the reflux may be related to the extensive dissection and the tension needed to achieve approximation of the two esophageal segments during repair of the atresia. Some aggravation factors leading to respiratory complications, such as tracheomalacia, and tracheal compression by innominate artery would be an indication for an early anti-reflux operation.