Oesophageal atresia without major cardiovascular anomalies: Is management justified at a district paediatric surgical institution?
- PMID: 33595544
- PMCID: PMC8109746
- DOI: 10.4103/ajps.AJPS_113_20
Oesophageal atresia without major cardiovascular anomalies: Is management justified at a district paediatric surgical institution?
Abstract
Background: Oesophageal atresia lacks sufficiently documented treatment approach, as guidelines are based rather on the opinion of experts than on systematic data. We aimed to answer the question if treatment of patients without major cardiovascular anomalies could be justified at a peripheral paediatric surgical institution, by evaluating the outcome of surgical correction.
Methods: Thirty-three neonates underwent surgery for correction of oesophageal atresia during a period of 20 years. They were categorised into two time-period groups, to follow-up the evolution of surgical intervention and complications through time. Evaluation of post-operative outcome and morbidity was performed. The results were related to those of our recent cross-sectional study on families having experienced oesophageal atresia performed years after repair, regarding the long-term quality of life.
Results: A shift from staged to primary repair occurred throughout time in the patients with a marginal long gap between proximal and distal oesophagus (P = 0.008). Anastomotic stenosis was the major short-term complication encountered, treated with post-operative dilation sessions. Dysphagia and reflux were the most common long-term complications.
Conclusions: Oesophageal atresia without severe cardiovascular abnormalities could be treated at a peripheral paediatric surgical department with satisfactory outcomes. However, qualified paediatric surgeons, anaesthesiologists and neonatologists and the availability of neonatal intensive care unit should be definitively required.
Keywords: Management; morbidity; oesophageal atresia; outcome; stenosis.
Conflict of interest statement
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References
-
- Krishnan U, Mousa H, Dall’Oglio L, Homaira N, Rosen R, Faure C, et al. ESPGHAN-NASPGHAN guidelines for the evaluation and treatment of gastrointestinal and nutritional complications in children with esophageal atresia-tracheoesophageal fistula. J Pediatr Gastroenterol Nutr. 2016;63:550–70. - PubMed
-
- Mazurak M, Patkowski D. The visionaries, the virtuosos, and the history of congenital esophageal atresia surgery. Ann Thorac Surg. 2018;106:305–8. - PubMed
-
- Muensterer OJ, Berdon WE. From Vogt to Haight and Holt to now: The history of esophageal atresia over the last century. Pediatr Radiol. 2015;45:1230–5. - PubMed
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