Transanastomotic Tube Use and Anastomotic Stricture: A Multicenter Prospective Randomized Trial in Neonates Undergoing Repair of Type C Esophageal Atresia With Distal Tracheoesophageal Fistula.
Ann SurgJun 18, 2026 (epub)
Justin Lee, Katie W Russell, Caitlin Smith et al.
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In 30 seconds
This multicenter randomized trial evaluated the impact of transanastomotic tube (TT) placement on anastomotic stricture (AS) in 142 neonates undergoing repair of type C esophageal atresia with distal tracheoesophageal fistula. The study found no significant difference in AS rates between the TT group (53.7%) and the no TT group (47.3%; P = 0.45), with anastomotic tension identified as the strongest predictor of stricture.
Key findings
- AS rates were 47.3% in the no TT group and 53.7% in the TT group (P = 0.45).
- TT use was not independently associated with stricture (OR = 1.18; P = 0.64).
- Moderate-to-severe anastomotic tension was an independent predictor of stricture (OR = 2.45; P = 0.026).
Why it matters
Understanding the factors influencing anastomotic stricture risk is crucial for improving surgical outcomes in neonates with esophageal atresia. This study highlights the importance of surgical assessment over the use of transanastomotic tubes.