What is the incidence of Barrett's and gastric metaplasia in esophageal atresia/tracheoesophageal fistula (EA/TEF) patients?

Sathyaprasad Burjonrappa, S. Youssef, D. St-Vil

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective: Aim of the study was to document the incidence of gastric and intestinal metaplasia (Barrett's esophagus) in a closely followed group with EA/TEF, determine the efficacy of pH probe studies in diagnosing reflux and, moreover, to determine the lag period between the development of gastroesophageal reflux disease (GERD) and metaplasia. Materials and Methods: Patients who underwent EA/TEF correction were followed up over an 18-year period (1990-2009) with regular pH probe and endoscopy investigations. Biopsies were performed at 3 year intervals to evaluate for metaplastic changes in the esophageal epithelium. The interval between esophageal atresia correction and the development of erosive esophagitis, gastric metaplasia and Barrett's esophagus was determined. The development of complicated GERD was statistically correlated to age at detection. Results: 51 patients (28 male) underwent EA/TEF correction during the study period. The ages of the children followed up ranged from 7 months to 19 years. There were 5 Type A, 44 Type C and 2 Type D fistulas. 37 patients (5 Type A, 31 Type C, 1 Type D) had documented reflux and 14 did not. 17 (46%) of the patients with reflux underwent an anti-reflux operation. 4 of the 17 underwent 2 or more anti-reflux procedures. 21 patients had pH probe studies positive for reflux, 3 had negative pH probe studies after an anti-reflux operation. 18 of the 37 patients with reflux (about 50%) needed esophageal dilatation for either anastamotic or non-anastamotic strictures. Only 4/14 (28.5%) patients without reflux underwent dilatations and only in their first year of life (p=NS). 15 patients had mucosal abnormalities in endoscopic biopsies. 8 patients had gastric metaplasia and 1 patient had Barrett's esophagus. The mean age in the group with metaplasia (gastric and intestinal) was 13 years, which was significantly different from the mean age of the group (5.2 years) without mucosal changes (p

Original languageEnglish (US)
Pages (from-to)25-29
Number of pages5
JournalEuropean Journal of Pediatric Surgery
Volume21
Issue number1
DOIs
StatePublished - 2011
Externally publishedYes

Fingerprint

Barrett Esophagus
Stomach
Incidence
Metaplasia
Gastroesophageal Reflux
Dilatation
Age Groups
Esophageal atresia with or without tracheoesophageal fistula
Biopsy
Esophageal Atresia
Esophagitis
Endoscopy
Fistula
Pathologic Constriction
Epithelium

Keywords

  • Barrett's esophagus
  • esophageal atresia
  • metaplasia
  • screening

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Cite this

What is the incidence of Barrett's and gastric metaplasia in esophageal atresia/tracheoesophageal fistula (EA/TEF) patients? / Burjonrappa, Sathyaprasad; Youssef, S.; St-Vil, D.

In: European Journal of Pediatric Surgery, Vol. 21, No. 1, 2011, p. 25-29.

Research output: Contribution to journalArticle

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title = "What is the incidence of Barrett's and gastric metaplasia in esophageal atresia/tracheoesophageal fistula (EA/TEF) patients?",
abstract = "Objective: Aim of the study was to document the incidence of gastric and intestinal metaplasia (Barrett's esophagus) in a closely followed group with EA/TEF, determine the efficacy of pH probe studies in diagnosing reflux and, moreover, to determine the lag period between the development of gastroesophageal reflux disease (GERD) and metaplasia. Materials and Methods: Patients who underwent EA/TEF correction were followed up over an 18-year period (1990-2009) with regular pH probe and endoscopy investigations. Biopsies were performed at 3 year intervals to evaluate for metaplastic changes in the esophageal epithelium. The interval between esophageal atresia correction and the development of erosive esophagitis, gastric metaplasia and Barrett's esophagus was determined. The development of complicated GERD was statistically correlated to age at detection. Results: 51 patients (28 male) underwent EA/TEF correction during the study period. The ages of the children followed up ranged from 7 months to 19 years. There were 5 Type A, 44 Type C and 2 Type D fistulas. 37 patients (5 Type A, 31 Type C, 1 Type D) had documented reflux and 14 did not. 17 (46{\%}) of the patients with reflux underwent an anti-reflux operation. 4 of the 17 underwent 2 or more anti-reflux procedures. 21 patients had pH probe studies positive for reflux, 3 had negative pH probe studies after an anti-reflux operation. 18 of the 37 patients with reflux (about 50{\%}) needed esophageal dilatation for either anastamotic or non-anastamotic strictures. Only 4/14 (28.5{\%}) patients without reflux underwent dilatations and only in their first year of life (p=NS). 15 patients had mucosal abnormalities in endoscopic biopsies. 8 patients had gastric metaplasia and 1 patient had Barrett's esophagus. The mean age in the group with metaplasia (gastric and intestinal) was 13 years, which was significantly different from the mean age of the group (5.2 years) without mucosal changes (p",
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