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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. (2018) In Journal of Pediatric Surgery
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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Journal of Pediatric Surgery
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Elsevier
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  • scopus:85053209801
ISSN
1531-5037
DOI
10.1016/j.jpedsurg.2018.07.023
language
English
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yes
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5c3756fe-efce-4ba5-9340-0aae3f128b42
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2018-10-11 18:17:25
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2019-01-14 07:38:53
@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},
  month        = {09},
  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},
  year         = {2018},
}