The experience with 20 ceses of congenital esophageal atresia during the past 17 years from 1963 to 1979 at First Department of Surgery, Kyoto Prefectural University of Medicine was reviewed. The result was analyzed regarding the aspects of age at diagnosis, preoperative condition, and surgical procedures. Of the tweleve patients who underwent primary anastomosis of the esophagus from 1963 to 1971, only one (17%)was alive. On the other hand, 5 of 6 patients (83%) were alive from 1972 to 1979. This means that the surgical treament of esophageal atresia have definitely improved recently. The progress in anesthesia, postoperative care, and operative technique including use of extrapleural approach is the important contributing factor in achieving better result. Extrapleural approach especially has greately contributed to the imporovement in the treatment of congenital esophageal atresia. From these data, the protocol in our clinic the treatment of congenital esophageal atresia is to perform primary anastomosis following gastrostomy and to carry a single layer anasto-mosis of the esophagus using extrapleural approach.
