Overview: The Post-repair Issues and the Active Pursuit of Normalcy

The goal of this book is to help patients with esophageal and gastric disorders realize 70 or more good years, an admittedly stringent requirement. When starting life with a congenital defect as severe as esophageal atresia (EA), this goal is even more difficult to attain. The majority of patients with EA and a distal tracheoesophageal fistula (EA/TEF) have a shorter gap allowing an outwardly successful primary repair. Consequently, they are generally thought to be “getting along well.” The longer-term follow-up reports, however, from Finland, the Netherlands, and Canada as well as smaller studies have revealed that many of these patients have related, residual problems [1–16]. In these series, the adult patients who had EA/TEF repaired as infants were often found to have dysphagia and/or the consequences of gastroesophageal reflux (GER), potentially significant obstacles to the goal of 70 good years (see also Chaps. 50: “Long-Term Follow-Up of EA/TEF Patients” and 52: “Follow-Up of EA Repair: The Helsinki Experience”).