Oesophageal atresia: Diagnosis and prognosis in Dakar, Senegal

Fall, M; Mbaye, Papa Alassane; Horace, Haingonirina Joelle; Wellé, Ibrahima Bocar; Lo, Faty Balla; Traoré, M; Diop, Marième Soda; Ndour, Oumar; Ngom, Gabriel

doi:10.4103/0189-6725.170196

Cited by 13 publications

(23 citation statements)

References 27 publications

(33 reference statements)

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“…This finding was consistent with other reports. [ 13 , 30 ] Another independent risk factor for mortality in the present study was respiratory failure, which was consistent with other findings. [ 4 , 26 ] Respiratory failure caused by gastric fluid reflux into the lungs could increase the risk of mortality.…”

Section: Discussionsupporting

confidence: 93%

“…Many studies have indicated that CHD is the most common congenital malformation associated with EA, [ 3 , 15 , 25 ] and major CHD is considered an important risk factor for mortality in EA. [ 2 , 8 , 13 ] However, in a large sample survey conducted by Rokitansky et al, [ 25 ] the most common malformations in neonates with EA were cardiac defects (23.3%, 72/309), and a majority of the defects were simple CHD (83.3%, 60/72). In a nationwide survey conducted in the United States, most cardiovascular malformations were also simple CHD.…”

Section: Discussionmentioning

confidence: 99%

“…[ 5 , 10 – 13 ] This inconsistency might be because all CHD defects were minor defects in the current study, and only major CHD defects, such as single atrium/ventricle and transposition of the great arteries, were considered risk factors. [ 5 , 10 , 11 , 13 ]…”

Section: Discussionmentioning

confidence: 99%

“…In most current reports excluding neonates with lethal congenital anomalies, neonates with EA have an expected survival rate of more than 90%. [ 3 , 4 ] In addition to fatal malformations, factors such as prematurity, [ 3 ] low birth weight, [ 3 – 7 ] sepsis, [ 8 – 10 ] respiratory system complications, [ 6 , 8 , 11 , 12 ] anastomotic leak, [ 6 , 13 ] chromosome abnormality disorders, [ 14 ] low socioeconomic status, and delayed diagnosis [ 6 ] are associated with high mortality in EA.…”

Section: Introductionmentioning

confidence: 99%

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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: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A scoring system to predict mortality in infants with esophageal atresia

Jiang

Wang

et al. 2017

Medicine

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“…Major cardiac anomalies, severe prematurity and pre-operative estimation of long distance with bronchoesophagoscopy have been proposed as criteria to proceed to staged correction to avoid stenosis. [ 11 12 13 ] There is no precise definition of long-gap oesophageal atresia. Researchers proposed to consider as such, any atresia that cannot be repaired with a single operation.…”

Section: Discussionmentioning

confidence: 99%

Oesophageal Atresia without Major Cardiovascular Anomalies

Sinopidis

Athanasopoulou

Panagidis

et al. 2021

African Journal of Paediatric Surgery

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Background: Oesophageal atresia lacks sufficiently documented treatment approach, as guidelines are based rather on the opinion of experts than on systematic data. We aimed to answer the question if treatment of patients without major cardiovascular anomalies could be justified at a peripheral paediatric surgical institution, by evaluating the outcome of surgical correction. Methods: Thirty-three neonates underwent surgery for correction of oesophageal atresia during a period of 20 years. They were categorised into two time-period groups, to follow-up the evolution of surgical intervention and complications through time. Evaluation of post-operative outcome and morbidity was performed. The results were related to those of our recent cross-sectional study on families having experienced oesophageal atresia performed years after repair, regarding the long-term quality of life. Results: A shift from staged to primary repair occurred throughout time in the patients with a marginal long gap between proximal and distal oesophagus ( P = 0.008). Anastomotic stenosis was the major short-term complication encountered, treated with postoperative dilation sessions. Dysphagia and reflux were the most common long-term complications. Conclusions: Oesophageal atresia without severe cardiovascular abnormalities could be treated at a peripheral paediatric surgical department with satisfactory outcomes. However, qualified paediatric surgeons, anaesthesiologists and neonatologists and the availability of neonatal intensive care unit should be definitively required.

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Abdominal Neonatal Emergencies Considering Prenatal Diagnosis

Cassart

Avni

2017

Imaging Acute Abdomen in Children

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Oesophageal atresia: Diagnosis and prognosis in Dakar, Senegal

Cited by 13 publications

References 27 publications

A scoring system to predict mortality in infants with esophageal atresia

A scoring system to predict mortality in infants with esophageal atresia

Oesophageal Atresia without Major Cardiovascular Anomalies

Abdominal Neonatal Emergencies Considering Prenatal Diagnosis

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