Anastomotic leakage following surgery for esophageal atresia.
Of 199 neonates undergoing primary or delayed primary repair of esophageal atresia, 34 (17%) developed anastomotic leakage, 7 of which (3.5%) were major anastomotic disruptions. Infants with major leaks developed signs within 5 days and all required early reoperation, necessitating abandonment of the esophagus in 6. The remaining 27 were minor leaks demonstrated by water-soluble contrast studies and were successfully treated nonoperatively. Gastroesophageal reflux was unassociated with this complication but the use of braided silk sutures was associated with a significantly increased risk of anastomotic leakage when compared with polyglycolic acid (relative risk, 3.2) or polypropylene (relative risk, 2.6) sutures. Following anastomotic leakage there was a significantly increased risk (relative risk, 2.04) of subsequent esophageal stricture formation.
Chittmittrapap
S
S
Hospital for Sick Children, London, England.
Spitz
L
L
Kiely
E M
EM
Brereton
R J
RJ
D000714:Anastomosis, Surgical; D004933:Esophageal Atresia / Q000601:surgery*; D004940:Esophageal Stenosis / Q000453:epidemiology; D004947:Esophagus / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D019476:Insect Proteins; D011183:Postoperative Complications / Q000453:epidemiology*; D011506:Proteins; D012086:Reoperation; D012307:Risk Factors; D047011:Silk; D013537:Sutures
D019476:Insect Proteins; D011506:Proteins; D047011:Silk