Conservative Management of Anastomotic Leak after Repair of Type C Esophageal Atresia: A Retrospective Audit.

Introduction: Anastomotic leak after primary repair of esophageal atresia is usually managed by conservative measures with excellent outcome. We have analyzed results in our patients with anastomotic leak after primary repair of esophageal atresia type C. Methodology: We did a retrospective review of patients of esophageal atresia operated at our center from January 1, 2019, to December 31, 2023. The data were retrieved from the Hospital Information Management System and analyzed. Results: A total of 162 patients were operated for esophageal atresia. Among these, primary anastomosis could be achieved in 125 patients. Anastomotic leak was documented in 49 (39.2%) patients. Forty-five among these patients were managed conservatively, while four underwent esophageal diversion. Among the patients managed conservatively, 52.38% survived and were discharged. A statistical comparison was done between patients who survived to discharge and those who expired. Two groups were compared to ascertain the factors associated with increased risk of mortality. Sepsis at admission, anastomotic tension, duration of period for stabilization before surgery, duration of surgery, time to presentation of anastomotic leak, time to attain full feeds, and cardiac anomaly were found to affect survival on univariate analysis. However, on multivariate analysis, only sepsis at admission was found to have a significant effect on survival. Conclusion: Conservative management is usually successful if adequate enteral feeds and control of leaked contents or sepsis can be ensured.