Primary repair of esophageal atresia is followed by multiple diagnostic and surgical procedures

• Published in: Journal of pediatric surgery Vol. 56; no. 12; pp. 2192 - 2199
• Main Authors: van Hoorn, Camille E, de Graaff, Jurgen C, Vlot, John, Wijnen, Rene MH, Stolker, Robert Jan, Schnater, J. Marco
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-12-2021
• Subjects: Development; Esophageal atresia; Pediatric surgery; Surgical procedures; Tracheoesophageal fistula; TEF; Pediatric surgery; POS; COS; Esophageal atresia; Development; VACTERL; ICU; Surgical procedures; EA; Tracheoesophageal fistula; PTS
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2021.06.004

•Over 50% of all esophageal atresia patients were diagnosed with comorbidities•Patients with esophageal atresia underwent median 4 surgeries during childhood•Patients with esophageal atresia underwent median 3 stricture dilatations
Children born with esophageal atresia (EA) face comorbidities and complications often requiring surgery and anesthesia. We aimed to assess all procedures performed under general anesthesia during their first 12 years of life.
We performed a retrospective cohort study about subsequent surgeries and procedures requiring general anesthesia in children born with type C EA between January 2007 and December 2017, with follow-up to March 2019.
Of 102 eligible patients, 63 were diagnosed with comorbidities, of whom 18 had VACTERL association. Follow-up time for all patients varied between 14 months and 12 years (median 7 years). The patients underwent total 637 procedures, median 4 [IQR2-7] per patient. In the first year of life, 464 procedures were performed, in the second year 69 and in the third year 29. Thirteen patients underwent no other procedures than primary EA repair. In 57 patients, 228 dilatations were performed. Other frequently performed procedures were esophagoscopy (n=52), urologic procedures (n=44) and abdominal procedures (n=33).
Patients with EA frequently require multiple anesthetics for a variety of procedures related to the EA, complications and comorbidities. This study can help care providers when counselling parents of a patient with an EA by giving them more insight into possible procedures they can be confronted with during childhood.