Surgical repair of long-gap esophageal atresia: A retrospective study comparing the management of long-gap esophageal atresia in the Nordic countries

Research output: Contribution to journalArticle


BACKGROUND: Several surgical procedures have been described in the reconstruction of long-gap esophageal atresia (LGEA). We reviewed the surgical methods used in children with LGEA in the Nordic countries over a 15-year period and the postoperative complications within the first postoperative year.

METHODS: Retrospective multicenter medical record review of all children born with Gross type A or B esophageal atresia between 01/01/2000 and 12/31/2014 reconstructed within their first year of life.

RESULTS: We included 71 children; 56 had Gross type A and 15 type B LGEA. Delayed primary anastomosis (DPA) was performed in 52.1% and an esophageal replacement procedure in 47.9%. Gastric pull-up (GPU) was the most frequent procedure (25.4%). The frequency of chromosomal abnormalities, congenital heart defects and other anomalies was significantly higher in patients who had a replacement procedure. The frequency of gastroesophageal reflux (GER) was significantly higher after DPA compared to esophageal replacement (p = 0.013). At 1-year follow-up the mean body weight was higher after DPA than after organ interposition (p = 0.043).

CONCLUSION: DPA and esophageal replacement procedures were equally applied. Postoperative complications and follow-up were similar except for the development of GER and the body weight at 1-year follow-up. Long-term results should be investigated.

TYPE OF STUDY: Treatment study.



  • Tatjana Stadil
  • Antti Koivusalo
  • Mikko Pakarinen
  • Audun Mikkelsen
  • Ragnhild Emblem
  • Jan F Svensson
  • Henrik Ehrén
  • Linus Jönsson
  • Jakob Bäckstrand
  • Helene Engstrand Lilja
  • Felipe Donoso
  • Jørgen Mogens Thorup
  • Thorstein Sæter
  • Lars Rasmussen
  • Rikke Neess Pedersen
  • Pernilla Stenström
  • Einar Arnbjörnsson
  • Kristján Óskarsson
  • Niels Qvist
External organisations
  • Odense University Hospital
  • University of Helsinki
  • Oslo university hospital
  • Karolinska Institutet
  • Queen Silvia Children’s Hospital
  • Uppsala University
  • Copenhagen University Hospital
  • St. Olav’s University Hospital
  • National University Hospital of Iceland
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Pediatrics
  • Otorhinolaryngology
  • Surgery
Original languageEnglish
Pages (from-to)423-428
JournalJournal of Pediatric Surgery
Issue number3
Early online date2018 Sep 1
Publication statusPublished - 2019
Publication categoryResearch