Esophageal atresia in three overseas departments compared with metropolitan France

Abstract

Background: Esophageal atresia (EA) is a rare defect in esophageal continuity, frequently associated with tracheoesophageal fistula. Data on EA in children from French Guiana and the French West Indies are lacking.

Objectives: The objective of this study was to compare characteristics and outcomes between patients with EA in three French Departments in the Americas (DFAs) and a cohort from metropolitan France.

Methods and settings: This was a retrospective, multicenter descriptive study of all children born with EA in French Guiana, Martinique, or Guadeloupe between 2008 and early 2021. Data were extracted from the French register (from 38 French medical centers), which records characteristics and outcomes from the prenatal period through 1 year of age (with two questionnaires centralized by the National Reference Center for Esophageal Anomalies through an exhaustive search using several methods, with double-checking and verification). The characteristics of infants from the three DFAs were compared with those from metropolitan France.

Results: Overall, 39 children from the DFAs were included, among whom 36 had surgery at a median age of 3 days postnatally (0-81 days). At 1 year of age, eight children (21 %) had died and seven were lost to follow-up. There were no differences among the DFAs regarding mortality (p = 0.318) or morbidity, apart from a greater rate of loss to follow-up in French Guiana than in Guadeloupe (p < 0.01). Compared with metropolitan France (total of 2205 children; 1960 children with an anastomosis, 97 children died at 1 year of age), children from the DFAs had higher rates of complications (36 % vs. 24 % in metropolitan France, p = 0.04), higher mortality (21 % vs. 4 % in metropolitan France, p < 0.01), and fewer rehospitalizations per child (1 vs. 2 in metropolitan France, p < 0.01).

Conclusion: The three overseas groups have similar characteristics and outcomes but significantly higher morbidity and mortality rates compared with metropolitan France.

Keywords: Esophageal atresia; France; French Guiana; Morbidity–mortality; West Indies.