Background: In most cases of pure oesophageal atresia without tracheo-oesophageal fistula a delayed primary
anastomosis can be achieved. The aim of this study is to clarify the procedure of choice in those
cases where this is impossible.
Case report: In a retrospective case note review we have examined the survival and functional outcome of
patients treated with different procedures over a 30-year period. Of the 14 cases, one baby with
Down syndrome died, seven underwent delayed primary anastomosis, four were treated with colonic interposition (three of whom developed anastomotic strictures), and two babies are thriving four years after gastric transposition.
Conclusions: In view of the long-term functional results and uneventful post-operative recovery the authors recommend gastric transposition in those cases in whom delayed primary anastomosis is not
achievable.

Keywords: Isolated oesophageal atresia, gastric transposition