A new approach for the salvage of unsuccessful esophageal atresia repair: a spiral myotomy and delayed definitive operation.

A staged approach consisting of (1) spiral myotomy (2 1/2 revolutions) to elongate the proximal esophagus with its distal end forming a cutaneous esophagostomy in the anterior chest, and (2) delayed reconstruction of the esophagus with an end-to-end anastomosis, has been successfully employed in a 1-year-old infant who had undergone an unsuccessful repair of tracheoesophageal atresia during the neonatal period.