title: Esophageal atresia and transitional care--step 1: a systematic review and meta-analysis of the literature to define the prevalence of chronic long-term problems.
abstract: BACKGROUND
  Esophageal atresia (EA) is a rare congenital anomaly with high infantile survival rates. The aim of this study was to outline the prevalence of common long-term problems associated with EA repair in patients older than 10 years of age.
  
  
  METHODS
  Original papers were identified by systematic searching of MEDLINE and EMBASE databases from January 1993 to July 2014. Fifteen articles (907 EA patients) met inclusion criteria.
  
  
  CONCLUSIONS
  This is the first systematic review aiming to quantify the prevalence of the long-term problems associated with EA. The main active medical conditions (pooled estimated prevalence) identified were the following: dysphagia (50.3%), gastroesophageal reflux disease with (40.2%) or without (56.5%) histological esophagitis, recurrent respiratory tract infections (24.1%), doctor-diagnosed asthma (22.3%), persistent cough (14.6%), and wheeze (34.7%). The prevalence of Barrett's esophagus (6.4%) was 4 and 26 times higher than the adult (1.6%) and pediatric (.25%) general populations. Adult and pediatric practitioners should focus on how to develop effective long-term follow-up and transitional care for these patients.
authors.affiliation: Department of Pediatric and Neonatal Surgery, St. George's Healthcare NHS Trust, University of London, London, UK.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Connor
authors.affiliation: Department of Pediatric and Neonatal Surgery, St. George's Healthcare NHS Trust, University of London, London, UK.
authors.forename: Laurie R
authors.initials: LR
authors.lastname: Springford
authors.affiliation: Population Health Research Institute, St. George's University of London, London, UK.
authors.forename: Venediktos V
authors.initials: VV
authors.lastname: Kapetanakis
authors.affiliation: Department of Pediatric and Neonatal Surgery, St. George's Healthcare NHS Trust, University of London, London, UK. Electronic address: stefano.giuliani@nhs.net.
authors.forename: Stefano
authors.initials: S
authors.lastname: Giuliani
mesh_terms: D002908:Chronic Disease; D004933:Esophageal Atresia / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D013997:Time Factors
keywords: Barrett’s esophagus; Esophageal atresia; Esophageal cancer; Gastroesophageal reflux; Long-term care; Review