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Surgical repair of long-gap esophageal atresia: A retrospective study comparing the management of long-gap esophageal atresia in the Nordic countries
Odense Univ Hosp, Surg Dept A, Sdr Blvd 29, DK-5000 Odense C, Denmark.
Univ Helsinki, Childrens Hosp, Dept Pediat Surg, Helsinki, Finland.
Univ Helsinki, Childrens Hosp, Dept Pediat Surg, Helsinki, Finland.
Oslo Univ Hosp, Rikshosp, Dept Gastr & Pediat Surg, Oslo, Norway;Oslo Univ Hosp, Ulleval, Dept Gastr & Pediat Surg, Oslo, Norway.
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2019 (English)In: Journal of Pediatric Surgery, ISSN 0022-3468, E-ISSN 1531-5037, Vol. 54, no 3, p. 423-428Article in journal (Refereed) Published
Abstract [en]

Background:

Several surgical procedures have been described in the reconstruction of long-gap esophageal atresia (LGEA). We reviewed the surgical methods used in children with LGEA in the Nordic countries over a 15-year period and the postoperative complications within the first postoperative year.

Methods:

Retrospective multicenter medical record review of all children born with Gross type A or B esophageal atresia between 01/01/2000 and 12/31/2014 reconstructed within their first year of life.

Results:

We included 71 children; 56 had Gross type A and 15 type B LGEA. Delayed primary anastomosis (DPA) was performed in 52.1% and an esophageal replacement procedure in 47.9%. Gastric pull-up (GPU) was the most frequent procedure (25.4%). The frequency of chromosomal abnormalities, congenital heart defects and other anomalies was significantly higher in patients who had a replacement procedure. The frequency of gastroesophageal reflux (GER) was significantly higher after DPA compared to esophageal replacement (p = 0.013). At 1-year follow-up the mean body weight was higher after DPA than after organ interposition (p = 0.043).

Conclusion:

DPA and esophageal replacement procedures were equally applied. Postoperative complications and follow-up were similar except for the development of GER and the body weight at 1-year follow-up. Long-term results should be investigated.

Type of study:

Treatment study.

Place, publisher, year, edition, pages
2019. Vol. 54, no 3, p. 423-428
Keywords [en]
Esophageal atresia, Long gap, Gross type A, Gross type B, Surgical repair, Postoperative complication
National Category
Surgery Pediatrics
Identifiers
URN: urn:nbn:se:uu:diva-379033DOI: 10.1016/j.jpedsurg.2018.07.023ISI: 000458782300009PubMedID: 30220451OAI: oai:DiVA.org:uu-379033DiVA, id: diva2:1295415
Available from: 2019-03-11 Created: 2019-03-11 Last updated: 2019-03-11Bibliographically approved

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Engstrand Lilja, HeleneDonoso, Felipe

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