Prevalence, characteristics, and survival of children with esophageal atresia: A 32‐year population‐based study including 1,417,724 consecutive newborns

Cassina, Matteo; Ruol, Michele; Pertile, Riccardo; Midrio, Paola; Piffer, Silvano; Vicenzi, Virginia; Saugo, Mario; Stocco, Carmen; Gamba, Piergiorgio; Clementi, Maurizio

doi:10.1002/bdra.23493

Cited by 76 publications

(73 citation statements)

References 22 publications

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“…Esophageal atresia is a rare congenital condition with an estimated prevalence varying between 1 and 2 in 5,000 live births in Europe. 1,2 The malformation is characterized by a discontinuity of the esophagus with or without tracheoesophageal fistula. Since the first successful primary repair of esophageal atresia in 1941, improvements in operative and perioperative care have led to better outcomes, and mortality has decreased to a single-digit range [3][4][5] with most deaths due to comorbidities.…”

Section: Introductionmentioning

confidence: 99%

ERNICA Consensus Conference on the Management of Patients with Esophageal Atresia and Tracheoesophageal Fistula: Diagnostics, Preoperative, Operative, and Postoperative Management

et al. 2019

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Introduction Many aspects of the management of esophageal atresia (EA) and tracheoesophageal fistula (TEF) are controversial and the evidence for decision making is limited. Members of the European Reference Network for Rare Inherited Congenital Anomalies (ERNICA) conducted a consensus conference on the surgical management of EA/TEF based on expert opinions referring to the latest literature. Materials and Methods Nineteen ERNICA representatives from nine European countries participated in the conference. The conference was prepared by item generation, item prioritization by online survey, formulation of a final list containing the domains diagnostics, preoperative, operative, and postoperative management, and literature review. The 2-day conference was held in Berlin in October 2018. Anonymous voting was conducted via an internet-based system. Consensus was defined when 75% of the votes scored 6 to 9. Results Fifty-two items were generated with 116 relevant articles of which five studies (4.3%) were assigned as level-1evidence. Complete consensus (100%) was achieved on 20 items (38%), such as TEF closure by transfixing suture, esophageal anastomosis by interrupted sutures, and initiation of feeding 24 hours postoperatively. Consensus ≥75% was achieved on 37 items (71%), such as routine insertion of transanastomotic tube or maximum duration of thoracoscopy of 3 hours. Thirteen items (25%) were controversial (range of scores, 1–9). Eight of these (62%) did not reach consensus. Conclusion Participants of the conference reached significant consensus on the management of patients with EA/TEF. The consensus may facilitate standardization and development of generally accepted guidelines. The conference methodology may serve as a blueprint for further conferences on the management of congenital malformations in pediatric surgery.

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Section: Introductionmentioning

confidence: 99%

ERNICA Consensus Conference on the Management of Patients with Esophageal Atresia and Tracheoesophageal Fistula: Diagnostics, Preoperative, Operative, and Postoperative Management

et al. 2019

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“…[1–4] With improvements in surgical and perioperative care, survival rates now exceed 90%. [4, 5] This increased survival prompts a need to focus on long-term complications.…”

Section: Introductionmentioning

confidence: 99%

“…[1–4] With improvements in surgical and perioperative care, survival rates now exceed 90%. [4, 5] This increased survival prompts a need to focus on long-term complications. The most common problems patients with EA are at risk for include: gastroesophageal reflux disease (GERD) with or without esophagitis, Barrett’s esophagus (BE), dysphagia, strictures, eosinophilic esophagitis, feeding and nutritional problems, recurrent respiratory tract infections, persistent cough, and wheezing.…”

Section: Introductionmentioning

confidence: 99%

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

Mousa

Krishnan

Hassan

et al. 2017

Curr Gastroenterol Rep

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EA patients are at high risk for gastroesophageal reflux and esophageal strictures, and the sequela that result. Extraintestinal manifestations of gastroesophageal reflux disease (GERD) can appear similar to other pathologic diagnoses commonly found in EA patients, such as congenital stricture, eosinophilic esophagitis, esophageal dysmotility, tracheomalacia, recurrent fistula, aspiration, etc. Therefore, it is important to have a standardized way to monitor for these issues. pH impedance allows for detection of nonacid reflux and the height of reflux, which are important in correlating symptoms with reflux episodes. A multidisciplinary approach is beneficial in evaluating and monitoring EA patients in the long term.

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“…While OA outcome research used to focus on respiratory or gastrointestinal morbidity, we have come to realise that growth is an important outcome measure too. Many of these children are born small for gestational age (SGA) or prematurely,1 4 and growth might be compromised by feeding difficulties, gastrointestinal problems, recurrent pulmonary infections, associated congenital malformations and genetic syndromes.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal evaluation of growth in oesophageal atresia patients up to 12 years

Vergouwe

Spoel

Beelen

et al. 2017

Arch Dis Child Fetal Neonatal Ed

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Prevalence, characteristics, and survival of children with esophageal atresia: A 32‐year population‐based study including 1,417,724 consecutive newborns

Cited by 76 publications

References 22 publications

ERNICA Consensus Conference on the Management of Patients with Esophageal Atresia and Tracheoesophageal Fistula: Diagnostics, Preoperative, Operative, and Postoperative Management

ERNICA Consensus Conference on the Management of Patients with Esophageal Atresia and Tracheoesophageal Fistula: Diagnostics, Preoperative, Operative, and Postoperative Management

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

Longitudinal evaluation of growth in oesophageal atresia patients up to 12 years

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