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Surgical repair of long-gap esophageal atresia : A retrospective study comparing the management of long-gap esophageal atresia in the Nordic countries

Stadil, Tatjana ; Koivusalo, Antti ; Pakarinen, Mikko ; Mikkelsen, Audun ; Emblem, Ragnhild ; Svensson, Jan F ; Ehrén, Henrik ; Jönsson, Linus ; Bäckstrand, Jakob and Lilja, Helene Engstrand , et al. (2019) In Journal of Pediatric Surgery 54(3). p.423-428
Abstract

BACKGROUND: Several surgical procedures have been described in the reconstruction of long-gap esophageal atresia (LGEA). We reviewed the surgical methods used in children with LGEA in the Nordic countries over a 15-year period and the postoperative complications within the first postoperative year.

METHODS: Retrospective multicenter medical record review of all children born with Gross type A or B esophageal atresia between 01/01/2000 and 12/31/2014 reconstructed within their first year of life.

RESULTS: We included 71 children; 56 had Gross type A and 15 type B LGEA. Delayed primary anastomosis (DPA) was performed in 52.1% and an esophageal replacement procedure in 47.9%. Gastric pull-up (GPU) was the most frequent... (More)

BACKGROUND: Several surgical procedures have been described in the reconstruction of long-gap esophageal atresia (LGEA). We reviewed the surgical methods used in children with LGEA in the Nordic countries over a 15-year period and the postoperative complications within the first postoperative year.

METHODS: Retrospective multicenter medical record review of all children born with Gross type A or B esophageal atresia between 01/01/2000 and 12/31/2014 reconstructed within their first year of life.

RESULTS: We included 71 children; 56 had Gross type A and 15 type B LGEA. Delayed primary anastomosis (DPA) was performed in 52.1% and an esophageal replacement procedure in 47.9%. Gastric pull-up (GPU) was the most frequent procedure (25.4%). The frequency of chromosomal abnormalities, congenital heart defects and other anomalies was significantly higher in patients who had a replacement procedure. The frequency of gastroesophageal reflux (GER) was significantly higher after DPA compared to esophageal replacement (p = 0.013). At 1-year follow-up the mean body weight was higher after DPA than after organ interposition (p = 0.043).

CONCLUSION: DPA and esophageal replacement procedures were equally applied. Postoperative complications and follow-up were similar except for the development of GER and the body weight at 1-year follow-up. Long-term results should be investigated.

TYPE OF STUDY: Treatment study.

LEVEL OF EVIDENCE: Level III.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Pediatric Surgery
volume
54
issue
3
pages
423 - 428
publisher
Elsevier
external identifiers
  • pmid:30220451
  • scopus:85053209801
ISSN
1531-5037
DOI
10.1016/j.jpedsurg.2018.07.023
language
English
LU publication?
yes
id
5c3756fe-efce-4ba5-9340-0aae3f128b42
date added to LUP
2018-10-11 18:17:25
date last changed
2024-04-15 13:08:07
@article{5c3756fe-efce-4ba5-9340-0aae3f128b42,
  abstract     = {{<p>BACKGROUND: Several surgical procedures have been described in the reconstruction of long-gap esophageal atresia (LGEA). We reviewed the surgical methods used in children with LGEA in the Nordic countries over a 15-year period and the postoperative complications within the first postoperative year.</p><p>METHODS: Retrospective multicenter medical record review of all children born with Gross type A or B esophageal atresia between 01/01/2000 and 12/31/2014 reconstructed within their first year of life.</p><p>RESULTS: We included 71 children; 56 had Gross type A and 15 type B LGEA. Delayed primary anastomosis (DPA) was performed in 52.1% and an esophageal replacement procedure in 47.9%. Gastric pull-up (GPU) was the most frequent procedure (25.4%). The frequency of chromosomal abnormalities, congenital heart defects and other anomalies was significantly higher in patients who had a replacement procedure. The frequency of gastroesophageal reflux (GER) was significantly higher after DPA compared to esophageal replacement (p = 0.013). At 1-year follow-up the mean body weight was higher after DPA than after organ interposition (p = 0.043).</p><p>CONCLUSION: DPA and esophageal replacement procedures were equally applied. Postoperative complications and follow-up were similar except for the development of GER and the body weight at 1-year follow-up. Long-term results should be investigated.</p><p>TYPE OF STUDY: Treatment study.</p><p>LEVEL OF EVIDENCE: Level III.</p>}},
  author       = {{Stadil, Tatjana and Koivusalo, Antti and Pakarinen, Mikko and Mikkelsen, Audun and Emblem, Ragnhild and Svensson, Jan F and Ehrén, Henrik and Jönsson, Linus and Bäckstrand, Jakob and Lilja, Helene Engstrand and Donoso, Felipe and Thorup, Jørgen Mogens and Sæter, Thorstein and Rasmussen, Lars and Pedersen, Rikke Neess and Stenström, Pernilla and Arnbjörnsson, Einar and Óskarsson, Kristján and Qvist, Niels}},
  issn         = {{1531-5037}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{423--428}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Pediatric Surgery}},
  title        = {{Surgical repair of long-gap esophageal atresia : A retrospective study comparing the management of long-gap esophageal atresia in the Nordic countries}},
  url          = {{http://dx.doi.org/10.1016/j.jpedsurg.2018.07.023}},
  doi          = {{10.1016/j.jpedsurg.2018.07.023}},
  volume       = {{54}},
  year         = {{2019}},
}