Evaluation of Risk Factors Affecting Anastomotic Leakage After Repair of Esophageal Atresia

Askarpour, Shahnam; Peyvasteh, Mehran; Javaherizadeh, Hazhir; Askari, Nasim

doi:10.1590/s0102-67202015000300003

Cited by 11 publications

(8 citation statements)

References 9 publications

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“…[ 6 , 7 , 27 ] Several factors are involved in the incidence of anastomotic leaks, including sepsis, poor suturing techniques, ischemia of the esophageal ends, friable lower segment, the type of suture, and excess anastomotic tension. [ 28 , 29 ] Therefore, there is no doubt that adequate preoperative assessments, superb surgical skills, and postoperative care may be helpful in reducing mortality in patients with EA.…”

Section: Discussionmentioning

confidence: 99%

A scoring system to predict mortality in infants with esophageal atresia

Jiang

Wang

et al. 2017

Medicine

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Esophageal atresia (EA) is a rare anomaly that mandates surgical intervention. Patients with EA often have complicated medical courses due to both esophageal anomalies and related comorbidities. Although several prognostic classification systems have been developed to decrease the mortality rate in EA, most systems focus only on the influence of the major anomaly, and external risk factors that could be influenced by the neonatal caregivers to a certain extent are not included. The aim of this study was to investigate the risk factors for in-hospital mortality in neonates with EA and develop a scoring model to predict mortality.In total, 198 infants with EA who were treated with surgical intervention at the Children's Hospital of Chongqing Medical University between March 2004 and June 2016 were included. The demographic information, clinical manifestations, laboratory testing, and outcomes during hospitalization were analyzed retrospectively. A predictive scoring model was developed according to the regression coefficients of the risk factors.The mortality rate was 18.1% (36/198). In the univariate analysis, higher incidences of prematurity, low birth weight, long gap, anastomotic leak, respiratory failure, postoperative sepsis, respiratory distress syndrome, pneumothorax, and septic shock were found in the nonsurvivor group than in the survivor group (P < .05). In the logistic regression analysis, anastomotic leak (OR: 10.75, 95% CI: 3.113–37.128), respiratory failure (OR: 4.104, 95% CI: 2.292–7.355), postoperative sepsis (OR: 3.564, 95% CI: 1.516–8.375), and low birth weight (OR: 8.379, 95% CI: 3.357–20.917) were associated with a high mortality rate. A scoring model for predicting death was developed with a sensitivity of 0.861, a specificity of 0.827, a positive predictive value of 0.524, and a negative predictive value of 0.963 at a cutoff of 2 points. The area under the receiver-operating characteristic curve of the score was 0.905 (95% CI, 0.863–0.948, P = .000) for death from EA. The mortality rate increased rapidly as the scores increased, and all patients with scores ≥5 died.Anastomotic leak, respiratory failure, postoperative sepsis, and low birth weight are independent risk factors for mortality in EA. Infants with a predictive score of 5 had a high risk of death.

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Section: Discussionmentioning

confidence: 99%

A scoring system to predict mortality in infants with esophageal atresia

Jiang

Wang

et al. 2017

Medicine

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“…Respiratory complications which was seen in 34.14% of the cases are multifactorial and may be due anastomotic leaks 9,10 , recurrence of fistula, and anastomotic stricture. Tracheomalacia was seen in 37.5% to 75% of the children who underwent surgery of esophageal atresia 11,12 .…”

Section: Discussionmentioning

confidence: 99%

Incidence of malnutrition, esophageal stenosis and respiratory complications among children with repaired esophageal atresia

Askarpour

Peyvasteh

DASHTYAN

et al. 2020

ABCD, arq. bras. cir. dig.

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Background: Esophageal atresia is congenital anomaly with high mortality. Surgical complications and changes in nutritional status are common problems after surgical correction. Aim: T o evaluate nutritional status, esophageal stenosis, and respiratory complications among children who had repaired esophageal atresia. Methods: Children aged >2 months old with repaired esophageal atresia were included in the current study. Gender, age, weight, and height were recorded for each case. Height for age and weight for age were calculated for each case. Results: According to weight for length percentile, 41.02% of the cases were underweight. Esophageal stenosis was seen in 54.76% of the obtained esophagograms. Conclusion: Underweight was present in 41.02 of the patients according to weight-for-height percentile.

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“…Respiratory complications which was seen in 34.14% of the cases are multifactorial and may be due anastomotic leaks 1 , 3 , recurrence of fistula, and anastomotic stricture. Tracheomalacia was seen in 37.5% to 75% of the children who underwent surgery of esophageal atresia 2 , 6 .…”

Section: Discussionmentioning

confidence: 99%

Incidence of Malnutrition, Esophageal Stenosis and Respiratory Complications Among Children With Repaired Esophageal Atresia

Askarpour

Peyvasteh

DASHTYAN

et al. 2020

ABCD, arq. bras. cir. dig.

Self Cite

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Background: Esophageal atresia is congenital anomaly with high mortality. Surgical complications and changes in nutritional status are common problems after surgical correction. Aim: To evaluate nutritional status, esophageal stenosis, and respiratory complications among children who had repaired esophageal atresia. Methods: Children aged >2 months old with repaired esophageal atresia were included in the current study. Gender, age, weight, and height were recorded for each case. Height for age and weight for age were calculated for each case. Results: According to weight for length percentile, 41.02% of the cases were underweight. Esophageal stenosis was seen in 54.76% of the obtained esophagograms. Conclusion: Underweight was present in 41.02 of the patients according to weight-for-height percentile.

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Evaluation of Risk Factors Affecting Anastomotic Leakage After Repair of Esophageal Atresia

Cited by 11 publications

References 9 publications

A scoring system to predict mortality in infants with esophageal atresia

A scoring system to predict mortality in infants with esophageal atresia

Incidence of malnutrition, esophageal stenosis and respiratory complications among children with repaired esophageal atresia

Incidence of Malnutrition, Esophageal Stenosis and Respiratory Complications Among Children With Repaired Esophageal Atresia

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