Upper East Regional Hospital Performs Groundbreaking Surgery on Two-Year-Old Child with Oesophageal Atresia and Distal Tracheoesophageal Fistula

By – Sadat Dabo 

The Upper East Regional Hospital in Bolgatanga has successfully completed a major surgical procedure on a two-year-old boy diagnosed with oesophageal atresia with distal tracheo-oesophageal fistula, a rare and complex congenital condition affecting the child’s food passage and airway

The approximately five-hour operation was performed by a team of specialist paediatric surgeons, anaesthetists, nurses and other medical professionals.
Hospital management says the child is currently stable and under close monitoring by the surgical team following the procedure

A complex condition from birth

Oesophageal atresia occurs when the oesophagus, the tube that carries food from the mouth to the stomach, fails to develop as a continuous passage.
In the child’s case, the oesophagus was blocked, while the lower section was abnormally connected to the trachea through a condition known as a tracheo-oesophageal fistula

The condition made it difficult for the child to safely swallow saliva or take food normally and exposed him to serious respiratory complications.
The child was first seen by the hospital’s medical team at about three days old, presenting with excessive saliva, feeding difficulties and breathing problems.
The medical team initially treated his respiratory condition and associated chest infection before undertaking a staged surgical approach

Life-saving treatment began shortly after birth

During the initial surgery, the upper portion of the oesophagus was brought out through the neck in a procedure known as an oesophagostomy, allowing saliva to drain safely

A feeding tube was also inserted directly into the stomach through the abdominal wall, a procedure known as gastrostomy, to provide the child with nutrition without requiring him to swallow normally

The abnormal connection between the oesophagus and airway was also closed to prevent stomach contents from entering the lungs

Following the procedure, the child became stable and was discharged with regular medical follow-up

Second major operation reconstructs food passage

After months of growth and continued medical care, the child reached the appropriate stage for definitive reconstruction

In the latest operation, the surgical team created a new pathway for food from the mouth to the stomach because the original lower oesophagus was not available for reconstruction

A segment of intestine was used to create the new food passage — a procedure known as intestinal interposition, or colon interposition when the colon is used

The reconstructed passage was brought through the chest and connected to the oesophagus in the neck, with the ultimate goal of allowing the child to eventually eat normally by mouth

Specialists collaborate on complex procedure

The surgery was led by Dr. Lawrence Kankpeyeng, Paediatric Surgeon, with support from Dr. Hope Glover-Addy, Consultant Paediatric Surgeon at Korle-Bu Teaching Hospital, and Dr. Ernest Kunfaa, Paediatric Surgeon at the University of Technology and Applied Sciences (UTAS)

Operating room nurses, anaesthetists and other supporting staff also contributed to the procedure.
Management of the Upper East Regional Hospital says the successful intervention demonstrates the importance of multidisciplinary teamwork and professional collaboration in providing specialised paediatric surgical care

Hospital cautions that recovery remains critical

Although the surgery has been successfully completed, hospital management says the immediate post-operative period remains critical.
The child will continue to be closely monitored to assess the functioning of the reconstructed food passage and his overall recovery

Once the medical team is satisfied with his progress, steps will be taken towards transitioning him from tube feeding to normal oral feeding

Management has commended all the surgical, paediatric, anaesthetic, nursing and supporting teams involved in the child’s care from the neonatal period through to the latest procedure

The hospital also acknowledged the contribution of specialists from Korle-Bu Teaching Hospital and UTAS, as well as the cooperation of the child’s family

The Upper East Regional Hospital says it remains committed to providing quality, specialised and compassionate healthcare, particularly for children requiring complex surgical interventions