Abstract
Purpose: The purpose of was to study the short- and long-term outcomes in the management of isolated esophageal atresia with different operative strategies. Methods: All patients undergoing type A atresia repair over a 15-year period were included. Demographic data, birth weight, gestational age, incidence of associated anomalies, management, and long-term outcomes were studied. Results: Fifteen patients with type A atresia (9 male) were treated in the study period. The mean gestational age was 35.5 weeks (range, 27-39 weeks), and the mean birth weight was 2179 g (range, 670-3520 g). Eight babies had associated anomalies. Thirteen patients underwent gastrostomy as the initial procedure, and 2 underwent the Foker procedure. In the delayed management group, 9 patients underwent primary anastomosis, with 2 patients needing proximal pouch myotomy. Two patients underwent a Collis gastroplasty. Two patients underwent a cervical esophagostomy and a gastric tube replacement at 4 months and 1 year, respectively. Eight patients (60%) in this group had anastomotic leaks. All patients are currently on prokinetics and proton pump inhibitors. Seven required antireflux surgery. The median length of hospital admission was 4 months (range, 3-19 months). The native esophagus was preserved in 13 (85%) of 15 babies. All patients are alive, and 14 of 15 are capable of feeding orally. Conclusions: Type A esophageal atresia continues to be associated with significant morbidity despite advances in surgical technique and intensive care.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 865-871 |
| Number of pages | 7 |
| Journal | Journal of Pediatric Surgery |
| Volume | 45 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 2010 |
| Externally published | Yes |
Fingerprint
Keywords
- Collis gastroplasty
- Esophagomyotomy
- Gastric tube replacement
- Isolated esophageal atresia
- Primary repair
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Surgery
Cite this
Type A esophageal atresia : a critical review of management strategies at a single center. / Burjonrappa, Sathyaprasad; Thiboutot, Eva; Castilloux, Julie; St-Vil, Dickens.
In: Journal of Pediatric Surgery, Vol. 45, No. 5, 05.2010, p. 865-871.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Type A esophageal atresia
T2 - a critical review of management strategies at a single center
AU - Burjonrappa, Sathyaprasad
AU - Thiboutot, Eva
AU - Castilloux, Julie
AU - St-Vil, Dickens
PY - 2010/5
Y1 - 2010/5
N2 - Purpose: The purpose of was to study the short- and long-term outcomes in the management of isolated esophageal atresia with different operative strategies. Methods: All patients undergoing type A atresia repair over a 15-year period were included. Demographic data, birth weight, gestational age, incidence of associated anomalies, management, and long-term outcomes were studied. Results: Fifteen patients with type A atresia (9 male) were treated in the study period. The mean gestational age was 35.5 weeks (range, 27-39 weeks), and the mean birth weight was 2179 g (range, 670-3520 g). Eight babies had associated anomalies. Thirteen patients underwent gastrostomy as the initial procedure, and 2 underwent the Foker procedure. In the delayed management group, 9 patients underwent primary anastomosis, with 2 patients needing proximal pouch myotomy. Two patients underwent a Collis gastroplasty. Two patients underwent a cervical esophagostomy and a gastric tube replacement at 4 months and 1 year, respectively. Eight patients (60%) in this group had anastomotic leaks. All patients are currently on prokinetics and proton pump inhibitors. Seven required antireflux surgery. The median length of hospital admission was 4 months (range, 3-19 months). The native esophagus was preserved in 13 (85%) of 15 babies. All patients are alive, and 14 of 15 are capable of feeding orally. Conclusions: Type A esophageal atresia continues to be associated with significant morbidity despite advances in surgical technique and intensive care.
AB - Purpose: The purpose of was to study the short- and long-term outcomes in the management of isolated esophageal atresia with different operative strategies. Methods: All patients undergoing type A atresia repair over a 15-year period were included. Demographic data, birth weight, gestational age, incidence of associated anomalies, management, and long-term outcomes were studied. Results: Fifteen patients with type A atresia (9 male) were treated in the study period. The mean gestational age was 35.5 weeks (range, 27-39 weeks), and the mean birth weight was 2179 g (range, 670-3520 g). Eight babies had associated anomalies. Thirteen patients underwent gastrostomy as the initial procedure, and 2 underwent the Foker procedure. In the delayed management group, 9 patients underwent primary anastomosis, with 2 patients needing proximal pouch myotomy. Two patients underwent a Collis gastroplasty. Two patients underwent a cervical esophagostomy and a gastric tube replacement at 4 months and 1 year, respectively. Eight patients (60%) in this group had anastomotic leaks. All patients are currently on prokinetics and proton pump inhibitors. Seven required antireflux surgery. The median length of hospital admission was 4 months (range, 3-19 months). The native esophagus was preserved in 13 (85%) of 15 babies. All patients are alive, and 14 of 15 are capable of feeding orally. Conclusions: Type A esophageal atresia continues to be associated with significant morbidity despite advances in surgical technique and intensive care.
KW - Collis gastroplasty
KW - Esophagomyotomy
KW - Gastric tube replacement
KW - Isolated esophageal atresia
KW - Primary repair
UR - http://www.scopus.com/inward/record.url?scp=77951526192&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77951526192&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2010.02.004
DO - 10.1016/j.jpedsurg.2010.02.004
M3 - Article
C2 - 20438915
AN - SCOPUS:77951526192
VL - 45
SP - 865
EP - 871
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 5
ER -