Outcome and management in infants with esophageal atresia - a single centre observational study.
2016 (English)In: Journal of Pediatric Surgery, ISSN 0022-3468, E-ISSN 1531-5037, Vol. 51, no 9, 1421-1425 p.Article in journal (Refereed) Published
Background/Purpose: A successful outcome in the repair of esophageal atresia (EA) is associated with a high quality pediatric surgical centre, however there are several controversies regarding the optimal management. The aim of this study was to investigate the outcome and management EA in a single pediatric surgical centre.
Methods: Medical records of infants with repaired EA from 1994 to 2013 were reviewed.
Results: 129 infants were included. Median follow-up was 5.3 (range 0.1-21) years. Overall survival was 94.6%, incidences of anastomotic leakage 7.0%, recurrent fistula 4.6% and anastomotic stricture 53.5% (36.2% within first year). In long gap EA (n = 13), delayed primary anastomosis was performed in 9 (69.2%), gastric tube in 3 (23.1%) and gastric transposition in one (7.7%) infants. The incidences of anastomotic leakage and stricture in long gap EA were, 23.1% and 69.2%, respectively. Peroperative tracheobronchoscopy and postoperative esophagography were implemented as a routine during the study-period, but chest drains were routinely abandoned.
Conclusion: The outcome in this study is fully comparable with recent international reports showing a low mortality but a significant morbidity, especially considering anastomotic strictures and LGEA. Multicenter EA registry with long-term follow up may help to establish best management of EA.
Place, publisher, year, edition, pages
2016. Vol. 51, no 9, 1421-1425 p.
IdentifiersURN: urn:nbn:se:uu:diva-304712DOI: 10.1016/j.jpedsurg.2016.03.010ISI: 000382243300005PubMedID: 27114309OAI: oai:DiVA.org:uu-304712DiVA: diva2:1033664