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

Abstract

We evaluated the outcome in infants with esophageal atresia (EA) treated in our department over the last two decades. The medical records of 147 infants treated from 1986 to 2005 were reviewed. Patient characteristics, associated anomalies, surgery and complications were recorded. We divided the material into two time-periods: 1986-1995 and 1996-2005; 125 patients or parents were interviewed regarding gastrointestinal function, respiratory symptoms and education. The incidence of major cardiac defects increased from 23 to 29% and the overall survival increased from 87 to 94%. Using Spitz' classification survival increased from 93.5 to 100% in group I and from 68.4 to 77.8% in group II. In group III, during the second time period, survival was 100% in three patients. The incidence of anastomotic leakage and recurrent fistula did not change over time. The rate of anastomotic strictures increased from 53 to 59% between the two time-periods. A primary anastomosis could be done in 85% of the patients during the second period versus 78% of the patients during the first period. Anti-reflux surgery was done in only 11 and 9%, respectively, during the two time-periods. In patients who were 16-20 years old, 40-50% had gastrointestinal and respiratory symptoms. Ninety percent of the patients attended normal school. The major difference between the periods 1986-1995 and 1996-2005 was an increased survival despite an increased incidence of major cardiac defects. Gastrointestinal and respiratory symptoms were frequent. Long-term follow-up and treatment of complications of esophageal atresia is important for this patient group.

Subspecialization may improve an esophageal atresia service but has not addressed declining trainee experience

“…Mortality, leak and fistula rates were similar to contemporary series [16][17][18][19][20].The current mortality rate of 7.6% compares with a 14% mortality in our previous institutional series (χ 2 = 2.8, P = .09) [21]. Compared with that series, Fig.…”

Experience in treating congenital esophageal atresiain China

“…However, there are some other surgeons who favor the ES operation because of the decreased rate of leak and stricture. In 2004, Touloukian and Seashore [13] reported their 35 years of experience with ES repair; and with several key steps (adequate mobilization of the upper pouch, limited circumferential dissection of the lower esophagus at the TEF, fistula ligature to obliterate the lumen, downward displacement of the upper segment with anchoring sutures to the side of the lower esophagus before opening the lumen, and single-layer anastomosis with fine sutures), they decreased the incidence of recurrent TEF to 7%, which was not higher than that in other reports [7,10,14]. In the present study, we mainly performed the ES operation.…”

The Perception of the Quality of Life in Turkish Children Who Have Undergone Surgical Correction of a Congenital Gastrointestinal and Abdominal Anomaly

“…12 A literature review has revealed few studies on HRQoL in children with congenital abnormalities and these are mostly from Northern European countries. 1,9,13,14 As QoL is a subjective, multidimensional experience of wellbeing that is culturally constructed more studies are needed to understand HRQoL in children with congenital abnormalities from various communities. 15 We came across only one study from Turkey on the QoL in children with anorectal malformations.…”