Transabdominal closure of tracheoesophageal fistula: a new procedure for the management of poor-risk esophageal atresia with tracheoesophageal fistula.

Nissen fundoplication results in closure of the tracheoesophageal fistula (TEF) without the necessity for a thoracic operation by preventing both the reflux of gastric contents into the lungs through the distal TEF, and leakage of air into the stomach of less than 30 cm H2O intrapulmonary pressure. This procedure can safely be used even for a poor-risk patient and adequate nutritional support (full-strength milk) can be provided immediately after the fundoplication by a gastrostomy tube because the gastric contents cannot reflux into the lungs. This procedure was performed on two patients with esophageal atresia and distal TEF in Waterston Group C and gave successful results.