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Risk factors for digestive morbidities after esophageal atresia repair.
Eur J Pediatr. 2020 Jul 09 [Online ahead of print]EJ

Abstract

Esophageal atresia with/without tracheoesophageal fistula (EA/TEF) is a congenital digestive tract anomaly that represents a major therapeutic challenge. Postoperative digestive morbidities such as gastroesophageal reflux disease (GERD) and esophageal stricture are common. The aim of this study was to identify the incidence of and potential risk factors for digestive morbidities after EA/TEF repair. We retrospectively reviewed all EA/TEF patients who underwent repair at a single institution between January 1999 and December 2018, excluding patients who died prior to discharge. Patient demographics, perioperative management, and postoperative GERD and esophageal stricture rates were collected. We performed univariate and multivariate analyses to examine risk factors associated with postoperative GERD and esophageal stricture. The study enrolled 58 infants (58.6% male, 17.2% with type A EA/TEF, 62.1% with associated anomalies). Postoperative GERD occurred in 67.2% of patients and was the most common digestive morbidity. Esophageal stricture occurred in 37.9% of patients after EA/TEF repair. Multivariate analysis showed that long-gap EA/TEF and postoperative GERD were independent risk factors for esophageal stricture after repair surgery.

Conclusion:

The incidence of postoperative GERD and esophageal stricture was 67.2% and 37.9%, respectively. The risk factors for postoperative esophageal stricture were long-gap EA/TEF and postoperative GERD. What is Known: • EA/TEF is a congenital digestive tract anomaly with a high postoperative survival rate but can be complicated by many long-term morbidities. What is New: • Long-gap EA/TEF and postoperative GERD are risk factors of anastomotic stricture after repair. • Surgeons and pediatricians should be highly experienced in managing anastomotic tension and the GERD.

Authors+Show Affiliations

Department of Pediatrics, National Taiwan University Children Hospital, National Taiwan University College of Medicine, No. 8, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan.Department of Pediatrics, National Taiwan University Children Hospital, National Taiwan University College of Medicine, No. 8, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan.Department of Pediatrics, National Taiwan University Children Hospital, National Taiwan University College of Medicine, No. 8, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan.Department of Pediatrics, National Taiwan University Children Hospital, National Taiwan University College of Medicine, No. 8, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan.Division of Pediatric Surgery, Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan.Division of Pediatric Surgery, Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan.Department of Pediatrics, National Taiwan University Children Hospital, National Taiwan University College of Medicine, No. 8, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan. hcchou@ntu.edu.tw.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32648144

Citation

Lu, Yi-Hsuan, et al. "Risk Factors for Digestive Morbidities After Esophageal Atresia Repair." European Journal of Pediatrics, 2020.
Lu YH, Yen TA, Chen CY, et al. Risk factors for digestive morbidities after esophageal atresia repair. Eur J Pediatr. 2020.
Lu, Y. H., Yen, T. A., Chen, C. Y., Tsao, P. N., Lin, W. H., Hsu, W. M., & Chou, H. C. (2020). Risk factors for digestive morbidities after esophageal atresia repair. European Journal of Pediatrics. https://doi.org/10.1007/s00431-020-03733-1
Lu YH, et al. Risk Factors for Digestive Morbidities After Esophageal Atresia Repair. Eur J Pediatr. 2020 Jul 9; PubMed PMID: 32648144.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for digestive morbidities after esophageal atresia repair. AU - Lu,Yi-Hsuan, AU - Yen,Ting-An, AU - Chen,Chien-Yi, AU - Tsao,Po-Nien, AU - Lin,Wen-Hsi, AU - Hsu,Wen-Ming, AU - Chou,Hung-Chieh, Y1 - 2020/07/09/ PY - 2020/05/10/received PY - 2020/07/03/accepted PY - 2020/06/23/revised PY - 2020/7/11/entrez KW - Anastomotic stricture KW - Esophageal atresia KW - GERD KW - Risk factors JF - European journal of pediatrics JO - Eur. J. Pediatr. N2 - Esophageal atresia with/without tracheoesophageal fistula (EA/TEF) is a congenital digestive tract anomaly that represents a major therapeutic challenge. Postoperative digestive morbidities such as gastroesophageal reflux disease (GERD) and esophageal stricture are common. The aim of this study was to identify the incidence of and potential risk factors for digestive morbidities after EA/TEF repair. We retrospectively reviewed all EA/TEF patients who underwent repair at a single institution between January 1999 and December 2018, excluding patients who died prior to discharge. Patient demographics, perioperative management, and postoperative GERD and esophageal stricture rates were collected. We performed univariate and multivariate analyses to examine risk factors associated with postoperative GERD and esophageal stricture. The study enrolled 58 infants (58.6% male, 17.2% with type A EA/TEF, 62.1% with associated anomalies). Postoperative GERD occurred in 67.2% of patients and was the most common digestive morbidity. Esophageal stricture occurred in 37.9% of patients after EA/TEF repair. Multivariate analysis showed that long-gap EA/TEF and postoperative GERD were independent risk factors for esophageal stricture after repair surgery.Conclusion: The incidence of postoperative GERD and esophageal stricture was 67.2% and 37.9%, respectively. The risk factors for postoperative esophageal stricture were long-gap EA/TEF and postoperative GERD. What is Known: • EA/TEF is a congenital digestive tract anomaly with a high postoperative survival rate but can be complicated by many long-term morbidities. What is New: • Long-gap EA/TEF and postoperative GERD are risk factors of anastomotic stricture after repair. • Surgeons and pediatricians should be highly experienced in managing anastomotic tension and the GERD. SN - 1432-1076 UR - https://www.unboundmedicine.com/medline/citation/32648144/Risk_factors_for_digestive_morbidities_after_esophageal_atresia_repair L2 - https://dx.doi.org/10.1007/s00431-020-03733-1 DB - PRIME DP - Unbound Medicine ER -
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