title: Study of 24 cases with congenital esophageal atresia: what are the risk factors?
abstract: BACKGROUND
  Recovery from esophageal atresia (EA) and tracheoesophageal fistula (TEF) has improved markedly over the years. But postoperative complications, however, have remained. This study evaluates recovery, preoperative, and postoperative status of patients with EA/TEF.
  
  
  METHODS
  A retrospective study review was undertaken in 24 patients with EA/TEF after primary anastomosis (January 1975 through September 2003).
  
  
  RESULTS
  There were no patients who had major cardiac anomalies or trisomy 18. In total, 17 of 24 (70.8%, group A) patients have survived and seven (29.2%, group B) have died. Birthweight and Apgar Scores in group A were significantly higher than in group B. The ratio of GAP (the distance of the location of the blind pouch from the ends of the upper and lower esophagus) to body length in group B was significantly higher than in group A. The birthweight and Apgar Scores in group A were significantly higher than in group B. When the authors compared their sample of cases by means of the Waterston classification, the Montreal classification and the Spitz classification, there were statistically significant differences between the results using the Waterston classification and the results using to the Spitz classification.
  
  
  CONCLUSIONS
  For the cases of EA surgery that were examined, the authors concluded that bodyweight at birth and the existence of pre-surgery respiratory system complications have a significant effect on post-surgery recovery, and that results appear to indicate the importance of classification using the Waterston classification and Spitz classification as a means of assessing the degree of risk. Results also appeared to indicate that the control of Respiratory Distress Syndrome throughout both the pre-surgery and post-surgery periods is critical.
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, Nihon University School of Medicine, Tokyo, Japan. ksugito@hotmail.com
authors.forename: Kiminobu
authors.initials: K
authors.lastname: Sugito
authors.forename: Tsugumichi
authors.initials: T
authors.lastname: Koshinaga
authors.forename: Mayumi
authors.initials: M
authors.lastname: Hoshino
authors.forename: Mikiya
authors.initials: M
authors.lastname: Inoue
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Goto
authors.forename: Taro
authors.initials: T
authors.lastname: Ikeda
authors.forename: Noritsugu
authors.initials: N
authors.lastname: Hagiwara
mesh_terms: D000015:Abnormalities, Multiple / Q000401:mortality / Q000601:surgery*; D004933:Esophageal Atresia / Q000150:complications / Q000401:mortality / Q000601:surgery*; D004944:Esophagoplasty; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007564:Japan; D008297:Male; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D014138:Tracheoesophageal Fistula / Q000150:complications / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome