Outcome and management in infants with esophageal atresia - A single centre observational study.
OBJECTIVE
A successful outcome in the repair of esophageal atresia (EA) is associated with a high quality pediatric surgical centre, however there are several controversies regarding the optimal management. The aim of this study was to investigate the outcome and management EA in a single pediatric surgical centre.


METHODS
Medical records of infants with repaired EA from 1994 to 2013 were reviewed.


RESULTS
129 infants were included. Median follow-up was 5.3 (range 0.1-21) years. Overall survival was 94.6%, incidences of anastomotic leakage 7.0%, recurrent fistula 4.6% and anastomotic stricture 53.5% (36.2% within first year). In long gap EA (n=13), delayed primary anastomosis was performed in 9 (69.2%), gastric tube in 3 (23.1%) and gastric transposition in one (7.7%) infants. The incidences of anastomotic leakage and stricture in long gap EA were, 23.1% and 69.2%, respectively. Peroperative tracheobronchoscopy and postoperative esophagography were implemented as a routine during the study-period, but chest drains were routinely abandoned.


CONCLUSIONS
The outcome in this study is fully comparable with recent international reports showing a low mortality but a significant morbidity, especially considering anastomotic strictures and LGEA. Multicenter EA registry with long-term follow up may help to establish best management of EA.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Felipe
F
Donoso
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Ann-Marie
AM
Kassa
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Elisabet
E
Gustafson
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Staffan
S
Meurling
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. Electronic address: helene.lilja@kbh.uu.se.
Helene Engstrand
HE
Lilja
D057868:Anastomotic Leak / Q000453:epidemiology; D004933:Esophageal Atresia / Q000401:mortality / Q000601:surgery*; D004944:Esophagoplasty; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
Esophageal atresia; Morbidity; Outcome; Tracheoesophageal fistula