Evolution of management of esophageal atresia with or without tracheoesophageal fistula (EA/TEF) across five decades at a single academic medical center
Vol. 15 No. 1 (2026), Articles
Vol. 15 No. 1 (2026)

Evolution of management of esophageal atresia with or without tracheoesophageal fistula (EA/TEF) across five decades at a single academic medical center

Articles
https://doi.org/10.7363/150108
Published 2026-04-09
Caitlin J. Cain-Trivette
Department of Surgery, NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY, USA
https://orcid.org/0000-0003-4141-275X
Emily Manin
Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
Alexa Turpin
Department of Surgery, NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY, USA
Anjile An
Division of Biostatistics, Department of Population Health Sciences, Weill Cornell Medical Center, New York, NY, USA
P. Stephen Oh
Division of Pediatric Surgery, Department of Surgery, NewYork-Presbyterian/Weill-Cornell Medical Center, New York, NY, USA
Shaun Steigman
Division of Pediatric Surgery, Good Samaritan University Hospital, West Islip, NY, USA
Demetri Merianos
Division of Pediatric Surgery, Department of Surgery, NewYork-Presbyterian/Weill-Cornell Medical Center, New York, NY, USA
Nitsana A. Spigland
Division of Pediatric Surgery, Department of Surgery, NewYork-Presbyterian/Weill-Cornell Medical Center, New York, NY, USA
Angela Kadenhe-Chiweshe
Division of Pediatric Surgery, Department of Surgery, NewYork-Presbyterian/Weill-Cornell Medical Center, New York, NY, USA
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Keywords

esophageal atresia
tracheoesophageal fistula
surgical procedures
operative
postoperative complications
infant
newborn
treatment outcome

How to Cite

Cain-Trivette, C. J., Manin, E., Turpin, A., An, A., Oh, P. S., Steigman, S., Merianos, D., Spigland, N. A., & Kadenhe-Chiweshe, A. (2026). Evolution of management of esophageal atresia with or without tracheoesophageal fistula (EA/TEF) across five decades at a single academic medical center. Journal of Pediatric and Neonatal Individualized Medicine (JPNIM), 15(1), e150108. https://doi.org/10.7363/150108
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Abstract

Background: Despite improved survival in esophageal atresia with or without tracheoesophageal fistula (EA/TEF), complications remain common. We evaluated surgical outcomes at our institution over time and compared them to published benchmarks.

Methods: We performed a retrospective single-center review of patients with EA/TEF treated between 2008 and 2023, comparing outcomes to a prior institutional cohort from 1975 to 1995. Patients were identified using ICD and CPT codes.

Results: A total of 132 patients were included across both cohorts. Patient characteristics were similar between groups. Operative repair increased from 84% to 100% (p = 0.001). Stricture (40% vs. 37%) and TEF recurrence (7% vs. 10%) rates remained stable and comparable to benchmarks. Leak rate decreased from 19% to 12%, lower than benchmark reports. Overall mortality dropped significantly from 22% to 6% (p = 0.012). Among high-risk Waterston C infants, survival improved markedly from 38% to 79% (p = 0.015).

Conclusion: EA/TEF survival has significantly improved, especially among high-risk infants with low birth weight and cardiac disease. While stricture and recurrence rates remain unchanged, leak rates have improved. These findings reflect evolving surgical practices and improved neonatal care.

https://doi.org/10.7363/150108
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