Esophageal atresia and transitional care—step 1: a systematic review and meta-analysis of the literature to define the prevalence of chronic long-term problems

A patient led, international study of long term outcomes of esophageal atresia: EAT 1

“…Dysphagia and reflux are well reported in the short and long term after OA repair and we see a high reported incidence of food 'getting stuck', a surrogate patient reported outcome for dysphagia, in agreement with published literature [8] [16]. Previous studies have reported reflux symptoms in nearly 50% of under 5's with a decreasing frequency with age.…”

“…It also importantly examines the often ignored quality of life issues faced by this patient group. The large size of this study group makes it more representative of the wider international population of OA patients than most of the existing literature which is limited to smaller national [4,10] and institutional data series [3,7,13] or meta-analyses [8]. The study participants are broadly representative of the wider population based on anatomy of original defect in comparison to EUROCAT figures [14].…”

“…Schneider et al went on to endoscope a cohort of adult OA patients and concerningly found that 67% of patients had histological evidence of oesophagitis and 43% Barrett's oesophagus [19]. Several other studies report an increased risk of Barrett's [9,20] in OA and whilst a definitive increased risk of oesophageal cancer in OA patients has yet to be proven [8,21] the frequency of reflux symptoms in this patient group and histological metaplastic changes mean more attention needs to be paid to the consideration of surveillance endoscopy and use of anti-reflux medication in the adult aged OA population.…”

“…Whilst our understanding of short term outcomes in infants with OA is good [4][5][6][7], longer term functional outcomes are more poorly understood with a limited research base [8][9][10]. There is increasing interest therefore in longer term outcome studies, and results of such studies potentially impact current practice in management of OA.…”

“…This may be especially important for transitional care as patients leave the care of the paediatric surgeon for the adult world. The current literature tends to be limited to small national [4,9] and institutional datasets or meta-analysis of such studies [8]. Patient reported outcomes (PROMS), as an adjunct to reporting of outcomes by physicians and surgeons are becoming increasingly recognised as very important for improving care in a variety of conditions [11,12].…”