Outcome of long gap esophageal atresia at 6 years: A prospective case control cohort study.

Abstract

BACKGROUND DATA:

EA is the most frequent congenital esophageal malformation. Long gap EA remains a therapeutic challenge for pediatric surgeons. A case case-control prospective study from a multi-institutional national French data base was performed to assess the outcome, at age of 1 and 6 years, of long gap esophageal atresia (EA) compared with non-long gap EA/tracheo-esophageal fistula (TEF). The secondary aim was to assess whether initial treatment (delayed primary anastomosis of native esophagus vs. esophageal replacement) influenced mortality and morbidity at ages 1 and 6 years.

METHODS:

A multicentric population-based prospective study was performed and included all patients who underwent EA surgery in France from January 1, 2008 to December 31, 2010. A comparative study was performed with non-long gap EA/TEF patients. Morbidity at birth, 1 year, and 6 years was assessed.

RESULTS:

Thirty-one patients with long gap EA were compared with 62 non-long gap EA/TEF patients. At age 1 year, the long gap EA group had longer parenteral nutrition support and longer hospital stay and were significantly more likely to have complications both early post-operatively and before age 1 year compared with the non-long gap EA/TEF group. At 6 years, digestive complications were more frequent in long gap compared to non-long gap EA/TEF patients. Tracheomalacia was the only respiratory complication that differed between the groups. Spine deformation was less frequent in the long gap group. There were no differences between conservative and replacement groups at ages 1 and 6 years except feeding difficulties that were more common in the native esophagus group.

CONCLUSIONS:

Long gap strongly influenced digestive morbidity at age 6 years.

• Authors: Agate Bourg, Frédéric Gottrand, Benoit Parmentier, Julie Thomas, Anne Lehn, Christian Piolat, Arnaud Bonnard, Rony Sfeir, Julie Lienard, Véronique Rousseau, Myriam Pouzac, Agnès Liard, Philippe Buisson, Aurore Haffreingue, Louis David, Sophie Branchereau, Véronique Carcauzon, Nicolas Kalfa, Marc-David Leclair, Hubert Lardy, Sabine Irtan, François Varlet, Thomas Gelas, Diana Potop, Marie Auger-Hunault
• Journal: Journal of pediatric surgery (J Pediatr Surg) Vol. 58 Issue 4 Pg. 747-755 (Apr 2023) ISSN: 1531-5037 [Electronic] United States
• PMID: 35970676 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Elsevier Inc. All rights reserved.

Topics

• Infant, Newborn
• Child
• Humans
• Infant
• Child, Preschool
• Esophageal Atresia (complications)
• Case-Control Studies
• Prospective Studies
• Tracheoesophageal Fistula (epidemiology, surgery, complications)
• Treatment Outcome
• Retrospective Studies