The intensive care and surgery of esophageal atresia: outcomes of treatment in the regional children’s hospital

Abstract

Проведен анализ интенсивной, респираторной и нутритивной поддержки. Комплексный подход позволил улучшить качество и уровень специализированной помощи детям с АП. Ключевые слова: атрезия пищевода, хирургия новорожденных, интенсивная терапия новорожденныхEsophageal atresia (EA) is the most common congenital abnormality of the oesophagus. The survival rate of patients with this defect varies from 86.9 % to 95 %. Seventy eight newborns with EA were treated from 2011 to 2017; 58.9 % were male children, 48.7 % were premature, 51.3 % had associated anomalies. Mortality was 10.25 % and was associated with severe prematurity and sepsis. Direct esophagoesophagoanastomosis was formed in 60 (76.9 %) children, cervical esophagostomy with gastrostomy -in 17 (21.8 %) children. Postoperative morbidity occurred in 76,9 % of the population, including 4 (6.7 %) cases with anastomotic leak and anastomotic stricture in 43 (71.7 %), in those patients, who had anastomosis; recurrent fistula in 2 (2.6 %), pneumonia in 22 (28.2 %) and late-onset sepsis in 13 (16.7 %). Our study also highlights issues related to respiratory support, nutritional support and antibiotic therapy. Integrated approach has improved the quality and level of specialized care for children with EA.