title: Prophylactic effect of H2 blocker for anastomotic stricture after esophageal atresia repair.
abstract: BACKGROUND
  Anastomotic stricture is the main complication after esophageal atresia (EA) repair. In this study, we assessed the efficacy of long-term prophylactic H2 blocker treatment in preventing stricture.
  
  
  METHODS
  Twenty-seven patients who had undergone primary repair for EA (Gross type C) were reviewed retrospectively. The patients were analyzed in two groups: the H2 blocker group (n = 13), in which the patients were treated with prophylactic H2 blocker; and the control group (n = 14), in which they were not. To assess anastomotic stricture, contrast esophagography was performed and the number of patients who required balloon dilatation was recorded.
  
  
  RESULTS
  Five patients (18.5%) required postoperative balloon dilatation within 1 year of primary repair. There was no difference in dilatation rate between the two groups. In the H2 blocker group, however, anastomotic stricture improved significantly in the late postoperative period relative to that in the early postoperative period. In contrast, in the control group, anastomotic stricture did not improve after a long postoperative period. The incidence of gastroesophageal reflux was 55.6%. Postoperative gastroesophageal reflux was a predisposing factor for balloon dilatation in the control group, but not in the H2 blocker group.
  
  
  CONCLUSIONS
  Long-term treatment with prophylactic H2 blocker may prevent anastomotic stricture caused by gastroesophageal reflux in the late postoperative period after EA repair.
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Naruhiko
authors.initials: N
authors.lastname: Murase
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Hiroo
authors.initials: H
authors.lastname: Uchida
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Kenitiro
authors.initials: K
authors.lastname: Kaneko
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Ono
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Makita
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Yokota
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects; D004933:Esophageal Atresia / Q000601:surgery*; D004940:Esophageal Stenosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
chemical_list: D006635:Histamine H2 Antagonists
keywords: anastomotic stricture; balloon dilatation; esophageal atresia; gastroesophageal reflux; prophylactic H2 blocker