title: Long-term morbidity in adolescents and young adults with surgically treated esophageal atresia.
abstract: OBJECTIVE
  To investigate the long-term morbidity of surgically treated esophageal atresia (EA) in adolescents and young adults and establish whether these long-term morbidities are affected by the type of EA.
  
  
  METHODS
  We reviewed the medical records, including backgrounds and associated conditions, of 69 long-term survivors of EA, aged >15 years. The long-term morbidities included neurodevelopmental abnormality, nutritional impairment (short height <-2SD, low BMI <18.5), subjective symptoms, and musculoskeletal deformities. Comparisons of the results were made between Gross A-type EA (n = 6) and Gross C-type EA (n = 63).
  
  
  RESULTS
  All patients underwent esophageal anastomosis without esophageal replacement. Cardiac anomalies and long gap were present in 26 and 18%, respectively. Esophageal dilatation, fundoplication, and aortopexy were performed in 40, 34, and 18%, respectively. The incidence of long gap and esophageal stenosis was higher in Gross A-type EA than in Gross C-type EA. The long-term morbidities included neurodevelopmental abnormality (13%), nutritional impairment (62%: as short height in 34% and as low BMI in 46%), subjective symptoms (14%), and musculoskeletal deformities (59%). There were no differences in the long-term morbidities between Gross A and Gross C.
  
  
  CONCLUSIONS
  The incidence of the long-term morbidities is high in adolescents and young adults, regardless of the type of EA. Early detection of morbidity is important to improve the long-term outcomes of EA.
authors.affiliation: Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan. okuyama@pedsurg.med.osaka-u.ac.jp.
authors.forename: Hiroomi
authors.initials: H
authors.lastname: Okuyama
authors.affiliation: Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Tazuke
authors.affiliation: Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Takehisa
authors.initials: T
authors.lastname: Uenoa
authors.affiliation: Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yamanaka
authors.affiliation: Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Takama
authors.affiliation: Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Ryuta
authors.initials: R
authors.lastname: Saka
authors.affiliation: Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodocho, Izumi, Osaka, 594-1101, Japan.
authors.forename: Keigo
authors.initials: K
authors.lastname: Nara
authors.affiliation: Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodocho, Izumi, Osaka, 594-1101, Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Usui
mesh_terms: D000293:Adolescent; D000714:Anastomosis, Surgical; D013505:Digestive System Surgical Procedures; D004933:Esophageal Atresia / Q000145:classification / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D018662:Fundoplication; D006330:Heart Defects, Congenital / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D009017:Morbidity; D009139:Musculoskeletal Abnormalities / Q000453:epidemiology*; D065886:Neurodevelopmental Disorders / Q000453:epidemiology*; D009748:Nutrition Disorders / Q000453:epidemiology*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Adulthood; Esophageal atresia; Long-term morbidity