Long-Term Prognosis of Successfully Operated Oesophageal Atresia - With Aspects on Physical and Psychological Development

Abstract

From 1966 to 1973, 43 oesophageal atresia patients with no other significant anomalies underwent successful anastomosis. The late mortalities of the 5 patients were due to the complications of gastro-oesophageal reflux and tracheal problems. These deaths and all the serious complications occurred before the age of 3 years. The survivors were followed up for a mean of 12.7 years and 34 of the 38 long-term survivors were re-examined by the author. The subjective results of the remaining 4 patients were obtained by means of a questionnaire. The results, according to Desjardins et al, were: "excellent" 31, "good" 6 and, "fair" 1. The growth of the patients was normal and the majority of them also possessed normal intelligence and body image. Oesophagograms revealed pathological peristalsis in every patient but only 1 of them demonstrated a somewhat narrowed anastomosis. Very few patients, however, complained of symptoms arising from the abnormal motility of the oesophagus. The long-term prognosis and the quality of life of oesophageal atresia patients seems good after the frequent problems which might occur in the early years have been overcome.

Growth and development after oesophageal atresia surgery: Need for long-term multidisciplinary follow-up

“…In contrast, in two cross-sectional studies from different centres in Finland normal physical growth was reported in children with a mean age of 12 years studied several decades ago (7,9), and Legrand and coworkers recently even found overweight/obesity in 9% of 57 type C OA-patients studied at a mean age of 13 years(10).…”

“…Only three cross-sectional studies on cognition in OA-patients at school age are available (7,25,26). In 1984, Lindahl reported normal intelligence at an age of 8.8 to 16.5 years (mean age 12.7 years) in a cohort of 33 OA-patients born between 1966 and 1973.…”

“…Long-term growth data Growth has mainly been described in cross-sectional studies (6)(7)(8)(9)(10)(11) and retrospective evaluations of medical charts(12-14). Gischler and co-workers evaluated longitudinal growth up till five years in a prospectively followed cohort of 23 OA-patients born from 1999 onwards; all but one patient had a type C-OA (15).…”

Outcome in neonates with esophageal atresia treated over the last 20 years

“…Lindahl et al [34] reported IQ in the normal range in children with EA. The results are probably dependant on the presence of associated congenital malformation and prematurity.…”

Mental health and psychosocial functioning in adolescents with esophageal atresia

“…Despite the challenges child and parents experience in the early years, most adult patients with EA seem to have a good quality of life [15,16]. There is a paucity of studies that have examined long-term psychological outcome of children with EA; and the results reporting psychosocial functioning are contradictory, ranging from comparable with those of healthy controls [11,15,17,18] to more emotional and learning problems [19,20]. Because these studies have few patients in each age group and different assessment procedures have been used, it is difficult to make any firm conclusions.…”