Long-term evaluation of esophageal function in patients treated at birth for esophageal atresia.
Dysphagia, gastroesophageal reflux (GER) and esophageal metaplasia are reported with various incidence in the long term follow-up of patients treated at birth for esophageal atresia (EA). To evaluate the long term outcomes 26 patients treated at birth for EA with Tracheo Esophageal Fistula (TEF) were examined 8-28 (mean 15.8) years later by clinical evaluation, including barium meal, fiberoptic upper GI endoscopy, 24 hour ambulatory two-channel pH-monitoring and stationary esophageal manometry. 50% of patients complained of dysphagia. Mild esophagitis was found in 20% of patients but GER was detected in only 16.7% of the cases. By morphological X-ray, esophageal anomalies were detected in 31% of cases without significant functional relevance. Hundred percent of patients had a disorganized peristaltic esophageal activity and a low amplitude of the esophageal contractions was observed in 58% of them. In our series, esophageal dismotilty seems to be the main consequence of EA without any relevant disturbance of normal nutritional habit.
Department of Pediatric Surgery, Niguarda Ca' Granda Hospital, Milan, Italy. vpatom@libero.it
V
V
Tomaselli
M L
ML
Volpi
C A
CA
Dell'Agnola
M
M
Bini
A
A
Rossi
A
A
Indriolo
D000293:Adolescent; D000328:Adult; D002648:Child; D003680:Deglutition Disorders / Q000453:epidemiology / Q000503:physiopathology; D004415:Dyspepsia / Q000453:epidemiology / Q000503:physiopathology; D004933:Esophageal Atresia / Q000503:physiopathology* / Q000601:surgery*; D004941:Esophagitis / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008365:Manometry; D015995:Prevalence; D014138:Tracheoesophageal Fistula / Q000453:epidemiology / Q000503:physiopathology