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Prolonged Use of Proton Pump Inhibitors as Stricture Prophylaxis in Infants with Reconstructed Esophageal Atresia

Stenström, Pernilla LU ; Anderberg, Magnus LU ; Börjesson, Anna LU and Arnbjörnsson, Einar LU (2016) In European Journal of Pediatric Surgery
Abstract

Introduction Proton pump inhibitors (PPIs) are used as prophylaxis, guarding against anastomotic stricture (AS) in the aftermath of reconstructed esophageal atresia (EA). The incidence of stricture formation was studied in this setting, comparing outcomes of 3- and 12-month PPI prophylactic regimens. Patients and Methods Patient characteristics (gestational age, birth weight, prevalence of chromosomal aberrations, and other malformations), as well as rates of survival, AS formation, and required balloon dilation, were recorded in the following therapeutic subsets: (1) all infants undergoing primary surgical anastomosis for EA in years 2010–2014 and given postoperative PPI prophylaxis for 12 months and (2) all infants similarly treated... (More)

Introduction Proton pump inhibitors (PPIs) are used as prophylaxis, guarding against anastomotic stricture (AS) in the aftermath of reconstructed esophageal atresia (EA). The incidence of stricture formation was studied in this setting, comparing outcomes of 3- and 12-month PPI prophylactic regimens. Patients and Methods Patient characteristics (gestational age, birth weight, prevalence of chromosomal aberrations, and other malformations), as well as rates of survival, AS formation, and required balloon dilation, were recorded in the following therapeutic subsets: (1) all infants undergoing primary surgical anastomosis for EA in years 2010–2014 and given postoperative PPI prophylaxis for 12 months and (2) all infants similarly treated for EA in years 2001–2009 but given postoperative PPI prophylaxis for 3 months only. Duration of follow-up was 1 year in each group. Results Patient characteristics and survival rates in 12-month (n = 33) and in 3-month (n = 30) treatment groups did not differ significantly. The prevalence of AS was 42%/43% in each group (12 months, 14/33; 3 months, 13/30; p = 1). Median number of dilations required was 3 (range, 1–9) per patient in each group (p = 0.69). Median age at initial dilation was 163 days and 63 days in 12- and 3-month groups, respectively (p = 0.04). Conclusion Development of AS in the first year after reconstruction of EA was not reduced by prolonged PPI prophylaxis (12 vs. 3 months), but initial balloon dilation procedures were performed later in infants who were treated longer.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
anastomotic stricture, balloon dilation, esophageal atresia, prophylactic proton pump inhibitor treatment
in
European Journal of Pediatric Surgery
publisher
Thieme
external identifiers
  • Scopus:84969980465
ISSN
0939-7248
DOI
10.1055/s-0036-1584179
language
English
LU publication?
yes
id
ba23c3d2-9271-447d-b137-5dd933f8ae30
date added to LUP
2016-06-14 13:45:23
date last changed
2017-02-12 04:33:34
@article{ba23c3d2-9271-447d-b137-5dd933f8ae30,
  abstract     = {<p> Introduction Proton pump inhibitors (PPIs) are used as prophylaxis, guarding against anastomotic stricture (AS) in the aftermath of reconstructed esophageal atresia (EA). The incidence of stricture formation was studied in this setting, comparing outcomes of 3- and 12-month PPI prophylactic regimens. Patients and Methods Patient characteristics (gestational age, birth weight, prevalence of chromosomal aberrations, and other malformations), as well as rates of survival, AS formation, and required balloon dilation, were recorded in the following therapeutic subsets: (1) all infants undergoing primary surgical anastomosis for EA in years 2010–2014 and given postoperative PPI prophylaxis for 12 months and (2) all infants similarly treated for EA in years 2001–2009 but given postoperative PPI prophylaxis for 3 months only. Duration of follow-up was 1 year in each group. Results Patient characteristics and survival rates in 12-month (n = 33) and in 3-month (n = 30) treatment groups did not differ significantly. The prevalence of AS was 42%/43% in each group (12 months, 14/33; 3 months, 13/30; p = 1). Median number of dilations required was 3 (range, 1–9) per patient in each group (p = 0.69). Median age at initial dilation was 163 days and 63 days in 12- and 3-month groups, respectively (p = 0.04). Conclusion Development of AS in the first year after reconstruction of EA was not reduced by prolonged PPI prophylaxis (12 vs. 3 months), but initial balloon dilation procedures were performed later in infants who were treated longer.</p>},
  author       = {Stenström, Pernilla and Anderberg, Magnus and Börjesson, Anna and Arnbjörnsson, Einar},
  issn         = {0939-7248},
  keyword      = {anastomotic stricture,balloon dilation,esophageal atresia,prophylactic proton pump inhibitor treatment},
  language     = {eng},
  month        = {04},
  publisher    = {Thieme},
  series       = {European Journal of Pediatric Surgery},
  title        = {Prolonged Use of Proton Pump Inhibitors as Stricture Prophylaxis in Infants with Reconstructed Esophageal Atresia},
  url          = {http://dx.doi.org/10.1055/s-0036-1584179},
  year         = {2016},
}