title: ESPGHAN-NASPGHAN Guidelines for the Evaluation and Treatment of Gastrointestinal and Nutritional Complications in Children With Esophageal Atresia-Tracheoesophageal Fistula.
abstract: Esophageal atresia (EA) is one of the most common congenital digestive anomalies. With improvements in surgical techniques and intensive care treatments, the focus of care of these patients has shifted from mortality to morbidity and quality-of-life issues. These children face gastrointestinal (GI) problems not only in early childhood but also through adolescence and adulthood. There is, however, currently a lack of a systematic approach to the care of these patients. The GI working group of International Network on Esophageal Atresia comprises members from ESPGHAN/NASPGHAN and was charged with the task of developing uniform evidence-based guidelines for the management of GI complications in children with EA.
  
  
  
  Thirty-six clinical questions addressing the diagnosis, treatment, and prognosis of the common GI complications in patients with EA were formulated. Questions on the diagnosis, and treatment of gastroesophageal reflux, management of "cyanotic spells," etiology, investigation and management of dysphagia, feeding difficulties, anastomotic strictures, congenital esophageal stenosis in EA patients were addressed. The importance of excluding eosinophilic esophagitis and associated GI anomalies in symptomatic patients with EA is discussed as is the quality of life of these patients and the importance of a systematic transition of care to adulthood. A systematic literature search was performed from inception to March 2014 using Embase, MEDLINE, the Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Clinical Trials, and PsychInfo databases. The approach of the Grading of Recommendations Assessment, Development and Evaluation was applied to evaluate outcomes. During 2 consensus meetings, all recommendations were discussed and finalized. The group members voted on each recommendation, using the nominal voting technique. Expert opinion was used where no randomized controlled trials were available to support the recommendation.
authors: *Department of Pediatric Gastroenterology, Sydney Children's Hospital †Discipline of Pediatrics, School of Women's and Children's Health, University of New South Wales, Sydney, Australia ‡Division of Pediatric Gastroenterology, Rady Children's Hospital §San Diego School of Medicine, University of California, San Diego ||Digestive Endoscopy and Surgery Unit, Bambino Gesu Children's Hospital-IRCCS, Rome, Italy ¶Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia #Aerodigestive Centre, Division of Gastroenterology and Nutrition, Boston Children's Hospital, Boston **Harvard Medical School, Harvard, MA ††Division of Pediatric Gastroenterology, Sainte-Justine Hospital ‡‡Department of Pediatrics, Université de Montréal, Montreal, Canada §§CHU Lille, University Lille, National Reference Center for Congenital Malformation of the Esophagus, Department of Pediatric Gastroenterology Hepatology and Nutrition, Lille, France.
authors: Usha
authors: U
authors: Krishnan
authors: Hayat
authors: H
authors: Mousa
authors: Luigi
authors: L
authors: Dall'Oglio
authors: Nusrat
authors: N
authors: Homaira
authors: Rachel
authors: R
authors: Rosen
authors: Christophe
authors: C
authors: Faure
authors: Frédéric
authors: F
authors: Gottrand
mesh_terms: D000293:Adolescent; D002648:Child; D019468:Disease Management; D004933:Esophageal Atresia / Q000150:complications* / Q000628:therapy; D006801:Humans; D011788:Quality of Life; D014138:Tracheoesophageal Fistula / Q000150:complications* / Q000628:therapy