Surgical repair of long-gap esophageal atresia: A retrospective study comparing the management of long-gap esophageal atresia in the Nordic countries.
Anastomosis, Surgical
/ adverse effects
Esophageal Atresia
/ surgery
Esophagoplasty
/ adverse effects
Esophagus
/ surgery
Humans
Infant
Infant, Newborn
Postoperative Complications
/ epidemiology
Replantation
/ statistics & numerical data
Retrospective Studies
Scandinavian and Nordic Countries
Treatment Outcome
Esophageal atresia
Gross type A
Gross type B
Long gap
Postoperative complication
Surgical repair
Journal
Journal of pediatric surgery
ISSN: 1531-5037
Titre abrégé: J Pediatr Surg
Pays: United States
ID NLM: 0052631
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
received:
02
02
2018
revised:
03
07
2018
accepted:
31
07
2018
pubmed:
18
9
2018
medline:
22
3
2019
entrez:
18
9
2018
Statut:
ppublish
Résumé
Several surgical procedures have been described in the reconstruction of long-gap esophageal atresia (LGEA). We reviewed the surgical methods used in children with LGEA in the Nordic countries over a 15-year period and the postoperative complications within the first postoperative year. Retrospective multicenter medical record review of all children born with Gross type A or B esophageal atresia between 01/01/2000 and 12/31/2014 reconstructed within their first year of life. We included 71 children; 56 had Gross type A and 15 type B LGEA. Delayed primary anastomosis (DPA) was performed in 52.1% and an esophageal replacement procedure in 47.9%. Gastric pull-up (GPU) was the most frequent procedure (25.4%). The frequency of chromosomal abnormalities, congenital heart defects and other anomalies was significantly higher in patients who had a replacement procedure. The frequency of gastroesophageal reflux (GER) was significantly higher after DPA compared to esophageal replacement (p = 0.013). At 1-year follow-up the mean body weight was higher after DPA than after organ interposition (p = 0.043). DPA and esophageal replacement procedures were equally applied. Postoperative complications and follow-up were similar except for the development of GER and the body weight at 1-year follow-up. Long-term results should be investigated. Treatment study. Level III.
Sections du résumé
BACKGROUND
BACKGROUND
Several surgical procedures have been described in the reconstruction of long-gap esophageal atresia (LGEA). We reviewed the surgical methods used in children with LGEA in the Nordic countries over a 15-year period and the postoperative complications within the first postoperative year.
METHODS
METHODS
Retrospective multicenter medical record review of all children born with Gross type A or B esophageal atresia between 01/01/2000 and 12/31/2014 reconstructed within their first year of life.
RESULTS
RESULTS
We included 71 children; 56 had Gross type A and 15 type B LGEA. Delayed primary anastomosis (DPA) was performed in 52.1% and an esophageal replacement procedure in 47.9%. Gastric pull-up (GPU) was the most frequent procedure (25.4%). The frequency of chromosomal abnormalities, congenital heart defects and other anomalies was significantly higher in patients who had a replacement procedure. The frequency of gastroesophageal reflux (GER) was significantly higher after DPA compared to esophageal replacement (p = 0.013). At 1-year follow-up the mean body weight was higher after DPA than after organ interposition (p = 0.043).
CONCLUSION
CONCLUSIONS
DPA and esophageal replacement procedures were equally applied. Postoperative complications and follow-up were similar except for the development of GER and the body weight at 1-year follow-up. Long-term results should be investigated.
TYPE OF STUDY
METHODS
Treatment study.
LEVEL OF EVIDENCE
METHODS
Level III.
Identifiants
pubmed: 30220451
pii: S0022-3468(18)30512-8
doi: 10.1016/j.jpedsurg.2018.07.023
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
423-428Informations de copyright
Copyright © 2018 Elsevier Inc. All rights reserved.