title: Long-term outcome of children with oesophageal atresia type III.
abstract: OBJECTIVE
  The aim of this study was to evaluate the outcome of patients with oesophageal atresia type III (EA), focusing on the presence of late sequelae and quality of life.
  
  
  METHODS
  This was a retrospective case ascertainment followed by clinical assessment of patients. The study parameters included the patients' demographic characteristics, associated abnormalities, presence of gastro-oesophageal reflux disease (GERD) and digestive or respiratory symptoms, results of a clinical examination to evaluate nutritional status, spirometry results and quality of life assessed using the PedsQL 4.0 questionnaire.
  
  
  RESULTS
  Of 81 patients with EA type III treated in our institution over a 10-year period, 57 (mean age 13.3 (SE 2.8) years) participated in the study. 39% of the patients underwent fundoplication and 46% presented with anastomotic stenosis requiring dilation. 75% of patients had normal nutritional status (16% were obese, 9% were undernourished). Only 19% of participants had no digestive symptoms; 61% had dysphagia and 35% had symptoms of GERD at the last follow-up. The main respiratory symptoms were chronic cough (19%) and dyspnoea on exertion (37%). Only 37% of patients had no respiratory symptoms. Spirometry showed that 50% of patients had proximal obstruction and/or pulmonary distension, and 11% had restriction syndrome. Their quality of life was good but was lower than in healthy controls (80 vs 84, p<0.05) and lower in patients born prematurely, with symptoms of GERD and with a barky cough.
  
  
  CONCLUSIONS
  The high frequency of late sequelae in EA type III justifies regular and multidisciplinary follow-up through to adulthood.
authors: Reference Center for Congenital Malformations of the Esophagus, Department of Pediatrics, Jeanne de Flandre Children's Hospital, 1 place de Verdun, Lille, France.
authors: Céline
authors: C
authors: Legrand
authors: Laurent
authors: L
authors: Michaud
authors: Julia
authors: J
authors: Salleron
authors: Dorothée
authors: D
authors: Neut
authors: Rony
authors: R
authors: Sfeir
authors: Caroline
authors: C
authors: Thumerelle
authors: Michel
authors: M
authors: Bonnevalle
authors: Dominique
authors: D
authors: Turck
authors: Frederic
authors: F
authors: Gottrand
mesh_terms: D000293:Adolescent; D002648:Child; D003680:Deglutition Disorders / Q000209:etiology; D004933:Esophageal Atresia / Q000150:complications / Q000601:surgery*; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology; D006801:Humans; D008297:Male; D009752:Nutritional Status; D011379:Prognosis; D011788:Quality of Life; D012120:Respiration Disorders / Q000209:etiology; D012189:Retrospective Studies