title: Morbidity and mortality in 46 patients with the VACTERL association.
abstract: During a 10-year period, 313 infants were treated at the Hospital for Sick Children for esophageal atresia, of whom 46 had features of the VACTERL association. These 46 patients had a mortality rate of 24%, most deaths being caused by cardiovascular abnormalities. Infants weighing less than 2,050 g had a mortality rate of 26%, double that of heavier infants. During the first year of life there was considerable morbidity resulting from the tracheoesophageal abnormalities. Whenever possible primary repair of the esophagus should be performed; however, many patients with VACTERL association had an unusually long gap between the two ends of the esophagus, and repair under tension was associated with a high incidence of complications. Of the 35 survivors, 25 are in a satisfactory, stable condition, but 10 still require treatment necessitating repeated admission to hospital. Anorectal, renal or skeletal anomalies rarely caused death, but, when severe, were associated with a poor quality of life.
authors.affiliation: Department of Pediatric Surgery, Hospital for Sick Children, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Iuchtman
authors.forename: R
authors.initials: R
authors.lastname: Brereton
authors.forename: L
authors.initials: L
authors.lastname: Spitz
authors.forename: E M
authors.initials: EM
authors.lastname: Kiely
authors.forename: D
authors.initials: D
authors.lastname: Drake
mesh_terms: D000015:Abnormalities, Multiple / Q000453:epidemiology* / Q000401:mortality; D004933:Esophageal Atresia / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male