In esophageal surgery of the infant, esophageal atresia is the main indication for reconstructive surgery, because malignomas are rare and caustic injuries are treated conservatively in nearly all cases. Ater exclusion of additional congenital anomalies a primary anastomosis should be the aim in all types of esophageal atresia. Even in most cases of ‘long-gap’ esophageal atresia in which the esophageal segments are too far apart for a primary anastomosis, additional methods for esophageal elongation usually allows secondary anastomosis within the first 3 months after birth without use of substitutes. Only when primary or secondary anastomosis of the two esophageal segments is obviously impossible, esophageal replacement with colon or gastric tubes is indicated. In these cases cervical esophagostomy and gastrostomy have to be performed before the definite procedure takes place, usually after the age of 6 months.

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1999
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