Surgical repair of long-gap esophageal atresia: A retrospective study comparing the management of long-gap esophageal atresia in the Nordic countries

TY - JOUR

T1 - Surgical repair of long-gap esophageal atresia

T2 - A retrospective study comparing the management of long-gap esophageal atresia in the Nordic countries

AU - Stadil, Tatjana

AU - Koivusalo, Antti

AU - Pakarinen, Mikko

AU - Mikkelsen, Audun

AU - Emblem, Ragnhild

AU - Svensson, Jan F

AU - Ehrén, Henrik

AU - Jönsson, Linus

AU - Bäckstrand, Jakob

AU - Lilja, Helene Engstrand

AU - Donoso, Felipe

AU - Thorup, Jørgen Mogens

AU - Sæter, Thorstein

AU - Rasmussen, Lars

AU - Pedersen, Rikke Neess

AU - Stenström, Pernilla

AU - Arnbjörnsson, Einar

AU - Óskarsson, Kristján

AU - Qvist, Niels

N1 - Copyright © 2018 Elsevier Inc. All rights reserved.

PY - 2019/3

Y1 - 2019/3

N2 - 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.

AB - 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.

U2 - 10.1016/j.jpedsurg.2018.07.023

DO - 10.1016/j.jpedsurg.2018.07.023

M3 - Journal article

C2 - 30220451

SN - 0022-3468

VL - 54

SP - 423

EP - 428

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

IS - 3

ER -