title: Long-term burden of care and radiation exposure in survivors of esophageal atresia.
abstract: BACKGROUND
  Patients with esophageal atresia with or without tracheoesophageal fistula (EA/TEF) historically have had a high risk of neonatal mortality but the majority of patients are now expected to live into adulthood. However, the long-term burden of care among recent EA/TEF survivors has not been documented.
  
  
  METHODS
  A single-institution retrospective review of newborns with EA/TEF treated from 2001-2005 was conducted, including initial and total hospitalization length of stay, and number of clinic visits and procedures requiring general anesthesia in the first three years of life. Exposure to and number of radiological studies involving ionizing radiation (IR) were recorded.
  
  
  RESULTS
  Seventy-one of 78 (91%) patients survived to discharge and 69 were included for analysis. Mean length of initial hospital stay was 51.3 (range 9-390) days. By age 3 years, patients required 4.5 (mean, range 1-23) procedures performed under general anesthesia, attended 13.5 (mean, range 3-40) outpatient visits and were exposed to 17.4 mSv (mean, range 3.0-59.9) of IR from 40 (mean, range 5-165) radiological studies.
  
  
  CONCLUSIONS
  Patients with EA/TEF need complex and frequent hospital-based care from infancy to early childhood. Opportunities to critically review clinical services and imaging needs should be explored to improve the experience of patients and their families.
authors.affiliation: Division of Pediatric General and Thoracic Surgery, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, Canada M5G 1X8. Electronic address: pzamiara2016@meds.uwo.ca.
authors.forename: Paul
authors.initials: P
authors.lastname: Zamiara
authors.affiliation: Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, Canada M5G 1X8. Electronic address: karen.thomas@sickkids.ca.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Thomas
authors.affiliation: Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, Canada M5G 1X8. Electronic address: bairbre.connolly@sickkids.ca.
authors.forename: Bairbre L
authors.initials: BL
authors.lastname: Connolly
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, Canada M5G 1X8. Electronic address: lanehillary@gmail.com.
authors.forename: Hillary
authors.initials: H
authors.lastname: Lane
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, Canada M5G 1X8. Electronic address: peggy.marcon@sickkids.ca.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Marcon
authors.affiliation: Division of Pediatric General and Thoracic Surgery, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, Canada M5G 1X8. Electronic address: priscilla.chiu@sickkids.ca.
authors.forename: Priscilla P
authors.initials: PP
authors.lastname: Chiu
mesh_terms: D002675:Child, Preschool; D017281:Cost of Illness; D004933:Esophageal Atresia / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D000069079:Radiation Exposure / Q000706:statistics & numerical data*; D011859:Radiography; D012189:Retrospective Studies; D014138:Tracheoesophageal Fistula / Q000000981:diagnostic imaging / Q000628:therapy*
keywords: Chronic disease; Esophageal atresia; Long-term follow up; Morbidity; Radiation exposure; Tracheoesophageal fistula