The burden of esophageal dilatations following repair of esophageal atresia

Campos, Jose; Tanny, Sharman P. Tan; Kuyruk, Sema; Sekaran, Prabhu; Hawley, Alisa; Brooks, Jo-Anne; Bekhit, Elhamy; Hutson, John M.; Crameri, Joseph; McLeod, Elizabeth; Teague, Warwick J.; King, Sebastian K.

doi:10.1016/j.jpedsurg.2020.02.018

Cited by 22 publications

(26 citation statements)

References 50 publications

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“…In this cohort, over 60% of cases (including all types of EA) required postoperative stricture dilatations. In these cases, a mean of four (interquartile range two to eight) dilatations per patient were needed [ 24 ]. This is consistent with data from Germany that showed stricture rates of 57% irrespective of the underlying type of atresia [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Esophageal Magnetic Compression Anastomosis in Esophageal Atresia Repair: A PRISMA-Compliant Systematic Review and Comparison with a Novel Approach

Harrison¹,

König

Chen

et al. 2022

Children

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The use of magnet compression to endoscopically create an esophageal anastomosis is an intriguing approach to esophageal atresia repair, but published cases with an existing available device have demonstrated mixed success. One major shortcoming has been the formation of subsequent severe, recalcitrant strictures after primary repair. To address the limitations of the existing device, we recently introduced and reported success with specially designed bi-radial magnets that exhibit a novel geometry and unique tissue compression profile. The aim of this study is to compare the outcomes using our novel device (novel group, NG) with those of previous reports which utilized the historical device (historic group, HG) in a PRISMA-compliant systematic review. Seven studies were eligible for further analysis. Additionally, one of our previously unreported cases was included in the analysis. Esophageal pouch approximation prior to primary repair was performed more frequently in the NG than in the HG (100% NG vs. 21% HG; p = 0.003). There was no difference in the overall postoperative appearance of postoperative stricture (95% HG vs. 100% NG; p = 0.64). The number of postoperative dilatations trended lower in the NG (mean 4.25 NG vs. 9.5 HG; p = 0.051). In summary, magnetic compression anastomosis adds a new promising treatment option for patients with complex esophageal atresia. Prior approximation of pouches and a novel magnet design have the potential to lower the rate of stricture formation.

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Section: Discussionmentioning

confidence: 99%

Esophageal Magnetic Compression Anastomosis in Esophageal Atresia Repair: A PRISMA-Compliant Systematic Review and Comparison with a Novel Approach

Harrison¹,

König

Chen

et al. 2022

Children

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“…We assessed the influences of neonatal characteristics, surgical type, and complications during the first year after birth. We compared type I EA with other EA types because the former is associated with a higher risk of surgical complications and comorbidities (19)(20)(21)(22).…”

Section: Ea Inmentioning

confidence: 99%

Nutritional status at age 1 year in patients born with esophageal atresia: A population-based, prospective cohort study

Depoortere

Lapillonne²,

Sfeir

et al. 2022

Front. Pediatr.

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ObjectiveDespite recent progress in caring for patients born with esophageal atresia (EA), undernutrition and stunting remain common. Our study objective was to assess nutritional status in the first year after birth with EA and to identify factors associated with growth failure.Study designWe conducted a population-based study of all infants born in France with EA between 2010 and 2016. Through the national EA register, we collected prenatal to 1 year follow-up data. We used body mass index and length-for-age ratio Z scores to define patients who were undernourished and stunted, respectively. Factors with P < 0.20 in univariate analyses were retained in a logistic regression model.ResultsAmong 1,154 patients born with EA, body mass index and length-for-age ratio Z scores at 1 year were available for about 61%. Among these, 15.2% were undernourished and 19% were stunted at the age of 1 year. There was no significant catch-up between ages 6 months and 1 year. Patients born preterm (41%), small for gestational age (17%), or with associated abnormalities (55%) were at higher risk of undernutrition and stunting at age 1 year (P < 0.05). Neither EA type nor surgical treatment was associated with growth failure.ConclusionUndernutrition and stunting are common during the first year after birth in patients born with EA. These outcomes are significantly influenced by early factors, regardless of EA type or surgical management. Identifying high-risk patient groups with EA (i.e., those born preterm, small for gestational age, and/or with associated abnormalities) may guide early nutritional support strategies.

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“…The most commonly used technique is rigid dilatation, followed by a combination of rigid and balloon dilatations and balloon dilatation alone. 10 The reported success rate is up to 97.2%. 11 The frequency and time interval between esophageal dilatation depend on the patient's pathogenic cause and response to treatment and the surgeon's expertise and preference.…”

Section: Discussionmentioning

confidence: 99%

Esophageal Perforation into the Pericardium in a 3-Year-Old Child with Esophageal Stricture: A Rare Complication Following Esophageal Dilatation

Nasser

Nassir²,

Awan

et al. 2022

European J Pediatr Surg Rep.

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Perforation of the esophagus during dilatation is a rare complication that might cause mortality. We present the report of a 3-year-old girl who was diagnosed with B cell acute lymphoblastic leukemia at 17 months of age. She experienced a complicated clinical course after chemotherapy was initiated, which included mucositis and acute pericarditis. She later developed an acquired esophageal stricture and tracheoesophageal fistula, which were managed with resection and primary anastomosis when she was in remission. Postoperatively, the patient developed a leak, which was treated conservatively. She subsequently developed a stricture that was treated successfully. On the fourth dilatation attempt and after she was sent home, she presented with persistent vomiting and low-grade fever and became vitally unstable on the same day, after stabilization, upper gastroenterology contrast revealed contrast filling the pericardium. She was managed conservatively with close observation and serial echocardiograms and then discharged home on day 18 in good condition after complete resolution of the pericardial effusion.

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The burden of esophageal dilatations following repair of esophageal atresia

Cited by 22 publications

References 50 publications

Esophageal Magnetic Compression Anastomosis in Esophageal Atresia Repair: A PRISMA-Compliant Systematic Review and Comparison with a Novel Approach

Esophageal Magnetic Compression Anastomosis in Esophageal Atresia Repair: A PRISMA-Compliant Systematic Review and Comparison with a Novel Approach

Nutritional status at age 1 year in patients born with esophageal atresia: A population-based, prospective cohort study

Esophageal Perforation into the Pericardium in a 3-Year-Old Child with Esophageal Stricture: A Rare Complication Following Esophageal Dilatation

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