Invited Commentary on: Defining an Anastomotic Stricture Following Oesophageal Atresia Repair

Of the surgical complications of oesophageal atresia (OA) repair, anastomotic leak and stricture are the most frequently discussed; a systematic review found that each was reported in approximately 70 % of publications describing outcomes or complications of OA [1]. Interestingly, a Delphi process involving multiple stakeholder groups to select quality indicators for OA did not include stricture as a quality indicator per se, instead including the number of dilatations and re-operations on the oesophagus (“e.g. resection of stricture”) as indicators [2]. Taking in account that patients with postoperative dysphagia without any structural evidence of a narrowing should not undergo dilatation there is no agreement on the definition of a stricture [3]. Instinctively, understanding of a stricture lies somewhere between the extremes of a narrowing so recalcitrant to dilatation that it requires surgery, and the ones responding to one or a very limited number of dilatations.