Anastomotic stricture prediction in patients with esophageal atresia with distal fistula.
Esophageal atresia
Esophagram
Risk factors
Stricture
Stricture index
Journal
Pediatric surgery international
ISSN: 1437-9813
Titre abrégé: Pediatr Surg Int
Pays: Germany
ID NLM: 8609169
Informations de publication
Date de publication:
22 Feb 2023
22 Feb 2023
Historique:
accepted:
07
02
2023
entrez:
22
2
2023
pubmed:
23
2
2023
medline:
25
2
2023
Statut:
epublish
Résumé
To investigate potential early risk factors for anastomotic stricture formation and assess the predictive role of post-operative esophagrams. A retrospective study of patients with esophageal atresia with distal fistula (EA/TEF) operated between 2011 and 2020. Fourteen predictive factors were tested for stricture development. Esophagrams were used to calculate early (SI1) and late (SI2) stricture index (SI = anastomosis diameter/upper pouch diameter). Of 185 patients operated for EA/TEF in the 10-year period, 169 patients met the inclusion criteria. Primary anastomosis was performed in 130 patients and delayed anastomosis in 39 patients. Stricture formed in 55 patients (33%) within 1 year from anastomosis. Four risk factors showed strong association with stricture formation in unadjusted models: long gap (p = 0.007), delayed anastomosis (p = 0.042), SI1 (p = 0.013) and SI2 (p < 0.001). A multivariate analysis showed SI1 as significantly predictive of stricture formation (p = 0.035). Cut-off values using a receiver operating characteristic (ROC) curve were 0.275 for SI1 and 0.390 for SI2. The area under the ROC curve demonstrated increasing predictiveness from SI1 (AUC 0.641) to SI2 (AUC 0.877). This study identified an association between long gap and delayed anastomosis with stricture formation. Early and late stricture indices were predictive of stricture formation.
Identifiants
pubmed: 36811679
doi: 10.1007/s00383-023-05423-z
pii: 10.1007/s00383-023-05423-z
pmc: PMC9947071
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
136Informations de copyright
© 2023. The Author(s).
Références
J Pediatr. 2020 Apr;219:70-75
pubmed: 31952847
J Pediatr Gastroenterol Nutr. 2016 Nov;63(5):550-570
pubmed: 27579697
Br J Radiol. 2003 Jan;76(901):26-31
pubmed: 12595322
Dis Esophagus. 2015 Apr;28(3):216-23
pubmed: 24456536
J Pediatr Surg. 2010 Jul;45(7):1459-62
pubmed: 20638524
J Laparoendosc Adv Surg Tech A. 2013 Jul;23(7):635-8
pubmed: 23758564
J Pediatr Surg. 2015 Jan;50(1):107-10
pubmed: 25598104
Am J Gastroenterol. 2009 Mar;104 Suppl 2:S2-4
pubmed: 19262542
Am J Surg. 2017 Apr;213(4):640-644
pubmed: 28057296
Pediatrics. 2006 Feb;117(2):e137-42
pubmed: 16390920
Pediatr Surg Int. 1998 Mar;13(2-3):76-8
pubmed: 9563012
Eur J Pediatr Surg. 2014 Feb;24(1):3-8
pubmed: 23934626
J Gastrointest Surg. 2017 Jun;21(6):927-935
pubmed: 28424985
J Pediatr Surg. 2006 Oct;41(10):1635-40
pubmed: 17011260
Cir Pediatr. 2020 Jul 01;33(3):119-124
pubmed: 32657095
Pediatr Surg Int. 2016 Sep;32(9):869-73
pubmed: 27461430
Pediatr Surg Int. 2013 Jun;29(6):601-5
pubmed: 23519549
Aliment Pharmacol Ther. 2011 Dec;34(11-12):1269-81
pubmed: 21999643
World J Gastrointest Pharmacol Ther. 2016 Nov 6;7(4):531-539
pubmed: 27867686
J Surg Res. 2017 Aug;216:172-178
pubmed: 28807203
J Laparoendosc Adv Surg Tech A. 2016 May;26(5):393-8
pubmed: 26895295
BMC Pediatr. 2020 Aug 24;20(1):400
pubmed: 32831054
PLoS One. 2014 Aug 25;9(8):e106149
pubmed: 25153838
Pediatr Surg Int. 2008 May;24(5):531-6
pubmed: 18351365
Br J Surg. 2013 Mar;100(4):515-21
pubmed: 23334932
J Pediatr Surg. 1999 Jan;34(1):70-3; discussion 74
pubmed: 10022146
Eur J Pediatr Surg. 2013 Jun;23(3):219-25
pubmed: 23737132
J Formos Med Assoc. 2021 Jan;120(1 Pt 2):404-410
pubmed: 32586720
J Pediatr Gastroenterol Nutr. 2019 Jul;69(1):45-51
pubmed: 30889131
J Pediatr Gastroenterol Nutr. 2018 Mar;66(3):516-554
pubmed: 29470322
Curr Gastroenterol Rep. 2017 Nov 25;19(12):65
pubmed: 29177550
J Pediatr Surg. 2022 Jun;57(6):975-980
pubmed: 35304025
Dis Esophagus. 2021 Jun 14;34(6):
pubmed: 32944735
Eur J Pediatr Surg. 2017 Apr;27(2):192-195
pubmed: 27214095
Eur J Pediatr Surg. 2017 Feb;27(1):50-55
pubmed: 27769086