Among the various congenital esophageal malformations, esophageal atresia is the most common, and about 4% of congenital esophageal atresia cases have congenital cardiovascular malformations, and another 6% have other malformations. According to the location of esophageal atresia and the presence of esophageal-tracheal fistula, congenital esophageal atresia can be divided into five types: 1. The proximal segment of the esophagus is blind and the distal segment passes into the posterior wall of the trachea, forming an esophagotracheal fistula. The proximal part of the esophagus passes into the posterior wall of the trachea, forming an esophagotracheal fistula with a blind distal end. 3.The proximal and distal segments of the esophagus are both blinded and pass into the trachea without esophagotracheal fistula, which accounts for 2%. 4. The proximal and distal segments of the esophagus both pass into the posterior wall of the trachea, forming two tracheoesophageal fistulas, which is also rare and accounts for 1%. 5. The esophageal lumen is patent without atresia, but the anterior wall of the esophagus is connected to the posterior wall of the trachea to form an esophagotracheal fistula, accounting for 4%. The typical clinical manifestations of congenital esophageal atresia are saliva that cannot and will not be swallowed and flows back into the oral cavity, salivation and foaming after birth, and air from the respiratory tract entering the gastrointestinal tract through the fistula, causing abdominal distension. Treatment of congenital esophageal atresia Congenital cases of esophageal atresia die within a few days after birth without treatment. Therefore, surgery should be performed as soon as possible to correct the deformity after a clear diagnosis. Before surgery, attention should be paid to appropriate rehydration, correction of dehydration and electrolyte imbalance; prevention and control of aspiration pneumonia; administration of antibiotics; maintenance of normal body temperature, placement of a fine catheter in the upper esophageal cavity, continuous negative pressure suction, or aspiration of oral secretions to prevent or reduce the aspiration of oral secretions into the lungs, and maintenance of ventilation and oxygen inhalation in cases of pulmonary inflammation or pulmonary atelectasis. Surgical operation: Usually a right lateral posterior thoracic incision is used to enter the chest through the 4th intercostal incision, the pleura is cut outside the pleura or incised, the odd vein is cut and ligated in the thoracic cavity, the lower esophagus is freed, a thin band is placed around it to facilitate traction when the esophagotracheal fistula is exposed in the posterior wall of the trachea, the fistula is cut at about 5 mm from the posterior wall of the trachea, the trachea is repaired with interrupted transverse sutures, and the fistula is covered with the adjacent pleura. Before the anterior wall of the anastomosis is completely sutured, a fine catheter preplaced through the nose or mouth is placed into the stomach through the anastomosis for postoperative decompression and feeding, or a separate gastrostomy is performed. The drainage tube is placed in the extrapleural or pleural cavity, and then removed after the anastomosis is confirmed to have healed by esophageal X-ray examination about 2-3 weeks after surgery, after which the anastomosis can be fed by mouth. In cases of premature infants weighing less than 1500 kg, with poor general condition or with severe congenital malformations of other organs, corrective surgery should be performed in stages. In the first stage of surgery, the esophagotracheal fistula is cut and sutured, and a gastrostomy is performed through an abdominal incision, and a catheter is placed in the upper esophagus for continuous negative pressure suction or a cervical esophagostomy to prevent the occurrence of aspiration pneumonia. Due to the advancement of thoracoscopic technology, some cases in Hubei Provincial Maternal and Child Health Hospital can be performed minimally invasive surgery without opening the chest.