Esophageal atresia and transitional care--step 1: a systematic review and meta-analysis of the literature to define the prevalence of chronic long-term problems

Abstract

Background: Esophageal atresia (EA) is a rare congenital anomaly with high infantile survival rates. The aim of this study was to outline the prevalence of common long-term problems associated with EA repair in patients older than 10 years of age.

Data sources: Original papers were identified by systematic searching of MEDLINE and EMBASE databases from January 1993 to July 2014. Fifteen articles (907 EA patients) met inclusion criteria.

Conclusions: This is the first systematic review aiming to quantify the prevalence of the long-term problems associated with EA. The main active medical conditions (pooled estimated prevalence) identified were the following: dysphagia (50.3%), gastroesophageal reflux disease with (40.2%) or without (56.5%) histological esophagitis, recurrent respiratory tract infections (24.1%), doctor-diagnosed asthma (22.3%), persistent cough (14.6%), and wheeze (34.7%). The prevalence of Barrett's esophagus (6.4%) was 4 and 26 times higher than the adult (1.6%) and pediatric (.25%) general populations. Adult and pediatric practitioners should focus on how to develop effective long-term follow-up and transitional care for these patients.

Keywords: Barrett’s esophagus; Esophageal atresia; Esophageal cancer; Gastroesophageal reflux; Long-term care; Review.