END-TO-END VERSUS END-TO-SIDE ANASTOMOSIS IN THE TREATMENT OF ESOPHAGEAL ATRESIA OR TRACHEO-ESOPHAGEAL FISTULA.
BACKGROUND
Dehiscence of esophageal anastomosis is frequent and there are still controversies which type of anastomosis is preferred to diminish its incidence .


OBJECTIVE
To compare end-to-end anastomosis versus end-to-side anastomosis in terms of anastomotic leakage, esophageal stricture and gastroesophageal reflux symptom.


METHODS
This study was carried out for two year starting from 2012. End-to-side and end-to-side anastomosis were compared in terms of anastomotic leakage, esophageal stricture, gastroesophageal reflux symptom, length of surgery and pack cell infusion.


RESULTS
Respectively to end-to-end and end-to-side anastomosis, duration of surgery was 127.63±13.393 minutes and 130.29±10.727 minutes (p=0.353); esophageal stricture was noted in two (5.9%) and eight (21.1%) cases (p=0.09); gastroesophageal reflux disease was detected in six (15.8%) and three (8.8%) cases (p=0.485); anastomotic leakage was found in five (13.2%) and one (2.9%) cases (p=0.203); duration of neonatal intensive care unit admission was significantly shorter in end-to-end (11.05±2.438 day) compared to end-to-side anastomosis (13.88±2.306 day) (p<0.0001).


CONCLUSIONS
There were no significant differences between end-to-end and end-to-side anastomosis except for length of neonatal intensive care unit admission which was significantly shorter in end-to-end anastomosis group.
Department of Pediatric Surgery, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Shahnam
S
Askarpour
Department of Pediatric Surgery, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Nasrollah
N
Ostadian
Department of Pediatric Surgery, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Mehran
M
Peyvasteh
Department of Pediatric Surgery, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Mostafa
M
Alavi
Department. of Pediatric Gastroenterology, Abuzar Children's Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Hazhir
H
Javaherizadeh
D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D057868:Anastomotic Leak / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D004933:Esophageal Atresia / Q000601:surgery*; D004940:Esophageal Stenosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D004947:Esophagus / Q000601:surgery*; D005764:Gastroesophageal Reflux / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D014138:Tracheoesophageal Fistula / Q000601:surgery*