Routine post-operative esophagram Is not necessary after repair of esophageal atresia

Introduction: Esophagrams are routinely performed following repair of esophageal atresia (EA) with or without tracheoesophageal fistula (TEF); however, its utility has not been validated. Methods: EA/TEF repair performed from 2003 to 2014 at a single pediatric hospital and from 2004 to 2014 in the Pediatric Health Information System (PHIS) database were retrospectively reviewed to determine utility of esophagrams. Results: Esophagram was performed in 99% of patients at our institution (N - 105). Clinical signs were seen prior to esophagram in patients whose leak changed clinical management. Esophagram on postoperative day <= 15 was performed in 66% of PHIS database patients (N = 3255). Esophagram did not change the incidence of chest tube placement, reoperation, or dilation. Patients who required a reoperation were less likely to have an esophagram than patients who did not require a reoperation (40.7% versus 65.7%, p < 0.001). Conclusion: Our data suggest that routine esophagram is not necessary in asymptomatic patients. (C) 2017 Elsevier Inc. All rights reserved.