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

Mousa, Hayat; Krishnan, Usha; Hassan, Maheen; Dall’Oglio, Luigi; Rosen, Rachel; Gottrand, Frédéric; Fauré, Christophe

doi:10.1007/s11894-017-0605-6

Cited by 31 publications

(29 citation statements)

References 161 publications

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“…physiotherapists, speech-language pathologists or occupational therapists, and social workers. 2,19,20,109,126,[154][155][156] Some centers have also included diagnostic and interventional radiologists and an intensivist. 157 Special emphasis is given to have regular evaluation and follow-up by psychologists because of growing concern about the long-term effect of EA-TEF on the quality of life of the patients and their families.…”

Section: Antibiotic Therapymentioning

confidence: 99%

Care recommendations for the respiratory complications of esophageal atresia‐tracheoesophageal fistula

Koumbourlis

Belessis

Cataletto

et al. 2020

Pediatric Pulmonology

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Tracheoesophageal fistula (TEF) with esophageal atresia (EA) is a common congenital anomaly that is associated with significant respiratory morbidity throughout life. The objective of this document is to provide a framework for the diagnosis and management of the respiratory complications that are associated with the condition. As there are no randomized controlled studies on the subject, a group of experts used a modification of the Rand Appropriateness Method to describe the various aspects of the condition in terms of their relative importance, and to rate the available diagnostic methods and therapeutic interventions on the basis of their appropriateness and necessity. Specific recommendations were formulated and reported as Level A, B, and C based on whether they were based on “strong”, “moderate” or “weak” agreement. The tracheomalacia that exists in the site of the fistula was considered the main abnormality that predisposes to all other respiratory complications due to airway collapse and impaired clearance of secretions. Aspiration due to impaired airway protection reflexes is the main underlying contributing mechanism. Flexible bronchoscopy is the main diagnostic modality, aided by imaging modalities, especially CT scans of the chest. Noninvasive positive airway pressure support, surgical techniques such as tracheopexy and rarely tracheostomy are required for the management of severe tracheomalacia. Regular long‐term follow‐up by a multidisciplinary team was considered imperative. Specific templates outlining the elements of the clinical respiratory evaluation according to the patients’ age were also developed.

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Section: Antibiotic Therapymentioning

confidence: 99%

Care recommendations for the respiratory complications of esophageal atresia‐tracheoesophageal fistula

Koumbourlis

Belessis

Cataletto

et al. 2020

Pediatric Pulmonology

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“…23,24 Slow feeding or lengthy mealtimes are categorized as symptoms that can be indicative of an underlying anastomotic stricture. 7,25 These symptoms are also associated with insufficient body weight in adult patients 26 and decreased, condition-specific HRQOL during childhood and adolescence. 22 Better knowledge of the association between specific feeding difficulties, such as lengthy mealtimes, and the presence of an anastomotic stricture could be of aid in clinical practice when it comes to calculating the optimal interval between anastomotic dilatation sessions.…”

Section: Clinical Predictors Of Feeding Difficultiesmentioning

confidence: 99%

“…[3][4][5][6] Long gap atresia, among other early identified risk factors, is associated with digestive long-term morbidity of EA. 2,7,8 Long-term morbidity can result in feeding difficulties, which is negatively associated with health-related quality of life (HRQOL) among pediatric patients. 9 Generally, feeding difficulties decline with age [10][11][12] and the total prevalence of feeding difficulties among EA patients is estimated between 6 and 79%.…”

Section: Introductionmentioning

confidence: 99%

“…9 Generally, feeding difficulties decline with age [10][11][12] and the total prevalence of feeding difficulties among EA patients is estimated between 6 and 79%. 7 Prevalence disparity might be explained by the lack of coherent nomenclature and definitions, the different ages and developmental stages of the cohorts studied, and patient selection (such as recruitment from EA support groups). Studies of feeding difficulties include both disease-related eating strategies (such as avoidance of particular foods and liberal fluid intake to ease eating) and physical symptoms associated with mealtimes (such as food impaction, coughing, and choking).…”

Section: Introductionmentioning

confidence: 99%

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Parent-Reported Feeding Difficulties among Children Born with Esophageal Atresia: Prevalence and Early Risk Factors

Abrahamsson

Gatzinsky

et al. 2020

Eur J Pediatr Surg

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Introduction We aimed to describe the prevalence of observable feeding difficulties during mealtimes among children with repaired esophageal atresia (EA) and to determine their early predictors. Materials and Methods A survey, based on parents' reports and concerning difficulties in EA children's nutritional intake, was performed with the help of 114 families of 2 to 17-year-old EA patients. Neonatal and clinical/surgical data were collected from medical records. Comparisons were made of the prevalence n (%) of feeding difficulties between children in three age groups (2 to 7 years, 8 to 12 years, or 13 to 17 years of age) using the Mantel-Haenszel chi-square test. Logistic regression identified outcome predictors (odds ratio: 95% confidence interval). Predictors with p ≤ 0.1 in the univariable analysis were included in multiple regression analysis (p < 0.05). Results Seventy-five percent of the young children aged 2 to 7, (median number of feeding difficulties: 2), 61% of school-aged children aged 8 to 12 (median number of feeding difficulties: 1), and 60% patients in the teenage group, aged 13 to 17, (median number of feeding difficulties: 1), reported feeding difficulties. Surgical complications after EA repair independently predicted children having a gastrostomy (p ≤ 0.01), using a food infusion pump (p ≤ 0.01), taking small portions to facilitate eating (p = 0.01), and needing >30 minutes to finish a main meal (p = 0.02). Congenital independent predictors were VACTERL, low birth weight, and preterm birth. Conclusion Parentally observed feeding difficulties were commonly reported during early childhood, although prevalence decreases in older age groups. Several congenital and surgical factors were identified as independent predictors of complicated nutritional intake patterns.

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“…Patients with EA most likely suffer from gastroesophageal reflux disease (GERD). 8 Children with EA/TEF have a greater incidence of laryngeal cleft than other free children. 9 Neonatal surgical repair of ET/TEF is usually lacks sufficient preoperative information about the anatomy of these structures.…”

Section: Tracheoesophageal Fistula and Vacterl Associationmentioning

confidence: 99%

Congenital tracheoesophageal, umbilical, vascular and meningeal fistulas

Haroun¹

2018

MOJAP

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Tracheoesophageal fistula and esophageal atresia are rare congenital abnormalities which represent two components of VACTERL association of anomalies. They are frequently associated with laryngeal cleft. Congenital umbilical fistulas result from failure of obliteration of the fetal vitellointestinal duct or urachus. Vitellointestinal duct abnormalities are rare and they include Meckel's diverticulum, vitelline cyst and vitellointestinal fistula. Urachal anomalies are very rare, and they include diverticula, cysts, sinuses and fistulas. Ultrasonography and fistulography are helpful investigations for the diagnosis of urachal fistulas; the fistula is surgically excised together with the adjoining apex of the urinary bladder. Congenital prepubic sinuses and urethroperineal fistulas are other rare anomalies. Congenital coronary artery fistulas may be also discovered between the coronary arteries and the four cardiac chambers or the great vessels of the heart. Coronary arteriovenous fistulas and absent ductus venosus with abnormal venous circulation could occur as rare congenital anomalies. Other rare congenital arteriovenous fistulas could exist in the thorax, abdomen, pelvis, and cranial and spinal meninges.

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

Cited by 31 publications

References 161 publications

Care recommendations for the respiratory complications of esophageal atresia‐tracheoesophageal fistula

Care recommendations for the respiratory complications of esophageal atresia‐tracheoesophageal fistula

Parent-Reported Feeding Difficulties among Children Born with Esophageal Atresia: Prevalence and Early Risk Factors

Congenital tracheoesophageal, umbilical, vascular and meningeal fistulas

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