The management of postoperative reflux in congenital esophageal atresia–tracheoesophageal fistula: a systematic review

Shawyer, Anna C.; D’Souza, Joanne; Pemberton, Julia; Flageole, Hélène

doi:10.1007/s00383-014-3548-0

Cited by 30 publications

(23 citation statements)

References 64 publications

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“…[17] This was true for both PPI and histamine-2-receptor antagonists (H2RAs). There is no evidence to justify prescribing a higher dose of PPI to EA patients, as there is no evidence of EA patients having an abnormally high acid secretion or showing a resistance to PPIs.…”

Section: Gastroesophageal Reflux Diseasementioning

confidence: 99%

How to Care for Patients with EA-TEF: The Known and the Unknown

Mousa

Krishnan

Hassan

et al. 2017

Curr Gastroenterol Rep

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EA patients are at high risk for gastroesophageal reflux and esophageal strictures, and the sequela that result. Extraintestinal manifestations of gastroesophageal reflux disease (GERD) can appear similar to other pathologic diagnoses commonly found in EA patients, such as congenital stricture, eosinophilic esophagitis, esophageal dysmotility, tracheomalacia, recurrent fistula, aspiration, etc. Therefore, it is important to have a standardized way to monitor for these issues. pH impedance allows for detection of nonacid reflux and the height of reflux, which are important in correlating symptoms with reflux episodes. A multidisciplinary approach is beneficial in evaluating and monitoring EA patients in the long term.

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Section: Gastroesophageal Reflux Diseasementioning

confidence: 99%

How to Care for Patients with EA-TEF: The Known and the Unknown

Mousa

Krishnan

Hassan

et al. 2017

Curr Gastroenterol Rep

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“…The most frequent gastrointestinal long-and short-term morbidities include gastroesophageal reflux disease (GERD), esophageal dysmotility, dysphagia, esophagitis, anastomotic stricture, feeding disorders, and growth retardation. [5][6][7][8] GERD symptoms consist of recurrent vomiting, failure to thrive, and acute or chronic respiratory problems due to reflux and/or aspiration. 9,10 The gold standard evaluation in GERD diagnostics is a 24-hour pH-metry which quantifies the esophageal acid exposure and has a high level of correlation with the presence of peptic esophagitis.…”

Section: Introductionmentioning

confidence: 99%

“…9,18 Conservative management of GERD with proton-pump inhibitors (PPIs) and H 2 receptor antagonists has been reported to be successful in reducing symptoms and achieving demonstrable weight gain in EA patients. 5 PPI is recommended as first-line therapy. However, this is based on a low level of evidence and lacks standardization.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Effectiveness of Antireflux Surgery in Esophageal Atresia Patients

et al. 2019

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Introduction Gastroesophageal reflux disease (GERD) is a common morbidity after esophageal atresia (EA) repair, and the antireflux procedure (ARP) is a way of treating GERD symptoms. The aim of this study was to evaluate whether reflux index (Ri) and growth were improved by ARP. Materials and Methods Ninety-nine individuals with EA treated at the Queen Silvia Children's Hospital in Gothenburg, Sweden, between 1997 and 2010 were followed prospectively according to a structured care program. Twenty-four-hour pH-metry (Ri) and growth were studied at birth, then at 1, 7, and 15 years of age. All the patients included had reached 7 years of age. Results Preoperatively, Ri was significantly higher (32%) in the ARP than the non-ARP group (10%). Postoperatively, no difference was seen between the groups. However, at 7 and 15 years of age, Ri was significantly higher in the ARP group than in the non-ARP group. Weight (standard deviation scores) was significantly lower in the ARP group at 1 and 7 years of age when compared with the non-ARP group, but these differences were not seen at birth and at 15 years of age. In a multivariate analysis, only birth weight remained a significant factor for low weight at 7 years of age. At 15 years of age, no risk factors for low body weight were found. Conclusion In the long term, ARP is not effective in reducing GERD as measured as Ri in EA patients. The ARP group had significantly lower weight at 1 and 7 years of age than the non-ARP group, but this was not the case at the age of 15.

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“…Proton pump inhibitors (PPIs) have been used to protect the esophageal anastomosis from acid gastroesophageal reflux in an attempt to diminish the risk of developing AS. However, evidence of the protective effect of PPIs is controversial [3, 4]. The timing of dilation procedures during the postoperative period, i.e., when and how often dilation is needed over the years, has not been reported.…”

Section: Introductionmentioning

confidence: 99%

Dilations of anastomotic strictures over time after repair of esophageal atresia

et al. 2016

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Aim of the studyAnastomotic strictures commonly occur in patients undergoing surgery for esophageal atresia (EA). The primary aim of this study was to determine the age distribution of dilation procedures for anastomotic strictures over the patient’s childhood after reconstruction of EA. The secondary aim was to evaluate the effect of postoperative proton pump inhibitors (PPIs) on the frequency of dilations.MethodsThis observational study was conducted at a single tertiary center of pediatric surgery. The times that dilations of strictures were performed were assessed during three study periods: 1983–1995, 2001–2009, and 2010–2014. PPIs were not used during the first period, and then, respectively, for 3 and 12 months postoperatively. The indications for dilation were signs of obstruction and/or radiological signs of stricture.Primary resultsA total of 131 children underwent esophageal reconstruction, and of those, 60 (46%) required at least 1 dilation procedure for strictures. There were no differences in the frequencies of dilation procedures between the three study periods (28/66, 18/32 and 14/33, respectively; P = 0.42). The overall median number of dilations per patient was 3 (range 1–21) with no differences between the study periods. The differences between ages at which the first dilation was performed during each study period were significant, as follows: 7, 2, and 8 months, respectively (P = 0.03). Fiftyone percent of all dilation procedures were performed during the first year of life, 16% during the second year, and 33% during years 2–15. Four children (2%) underwent >12 dilations.ConclusionThe first year of life was the time of greatest need for dilation of AS after reconstruction of EA; however, dilations were also performed several years later. PPIs did not affect the frequency of dilations during the first year of life.

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The management of postoperative reflux in congenital esophageal atresia–tracheoesophageal fistula: a systematic review

Cited by 30 publications

References 64 publications

How to Care for Patients with EA-TEF: The Known and the Unknown

How to Care for Patients with EA-TEF: The Known and the Unknown

Long-Term Effectiveness of Antireflux Surgery in Esophageal Atresia Patients

Dilations of anastomotic strictures over time after repair of esophageal atresia

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