2005, Number 4
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Cir Cir 2005; 73 (4)
Esophageal atresia: a second-level hospital experience
Baeza-Herrera C, López-Castellanos J, Atzin-Fuentes JL, Sanjuán-Fabián H
Language: Spanish
References: 31
Page: 259-262
PDF size: 89.82 Kb.
ABSTRACT
Introduction: In recent years, surgical correction of esophageal atresia with distal tracheoesophageal fistula has become increasingly successful. However, there is still a group of high-risk patients with specific factors in whom the mortality remains appreciable. These associated factors include weight, gestational age, associated malformations and respiratory distress.
Material and methods: This report analyzes the mortality in 80 newborn infants with variants of esophageal atresia with or without tracheoesophageal fistula who were treated from 1999 to 2003. Data were collected restrospectively from hospital and office records.
Results: We observed 42 male patients, 69 patients were C variety, all had more than 12 h of postnatal life, 34 were preterm newborn, 41 were classified A or B according to Waterston, and 41 died. A logistic regression analysis and χ
2 of the influence of each risk factor on mortality was performed. Relevant statistical significance was found in the studied variables.
Conclusions: Morbidity and mortality of esophageal atresia was higher due to identified risk factors.
REFERENCES
Spitz L. Esophageal atresia: past, present and future. J Pediatr Surg 1996;31:19-25.
2. Chavin K, Field G, Chandler J, et al. Save the child’s esophagus: management of major disruption after repair of esophageal atresia. J Pediatr Surg 1996;31:48-52.
3. González LCD, Franco MG, Juárez JJP. Influencia de los hallazgos quirúrgicos en el pronóstico de la atresia de esófago. Bol Med Hosp Infant Mex 1994;51:399-402.
4. González JFZ, Villegas FA. Atresia de esófago: morbiletalidad en el INP (1971-1999). Acta Pediatr Mex 2001;22:411-418.
5. Waterston DJ, Bonham Carter RE, Aberdeen E. Oesophageal atresia: traqueo-oesophageal fistula. A study of survival in 218 infants. Lancet 1962;1:819-822.
6. Manning BP, Morgan AR, Coran AG, et al. Fifty years’ experience with esophageal atresia and tracheoesophageal fistula. Beginning with Cameron Haight’s first operation in 1935. Ann Surg 1986;204: 446-453.
7. Spitz L, Kiely EM, Morecroft JA, Drake DP. Oesophageal atresia: at-risk groups for the 1990s. J Pediatr Surg 1994;29:723-725.
8. Schaarschmidt K, Willital GH, Jorch G, Kerremans J. Delayed primary reconstruction of an esophageal atresia with distal esophago-
tracheal fistula in an infant weighing less than 500 g. J Pediatr Surg 1992;27:1529-1531.
9. German CJ, Mahour GH, Woolley MM. Esophageal atresia and associated anomalies. J Pediatr Surg 1976;11:299-306.
10. Hands LJ, Dudley NE. A comparison between gap-length and Waterston classification as guide to mortality and morbidity after surgery for esophageal atresia. J Pediatr Surg 1986;21:404-406.
11. González LCD, Guerrero RP, Barrera MJL. Pronóstico de la atresia de esófago en niños. Rev Med IMSS 1981;19:511-518.
12. Lindhal H. Esophageal atresia: a simple technical detail aiding the mobilization and circular myotomy of the proximal segment. J Pediatr Surg 1987;22:113-114.
13. Lipshultz SG, Albanese CT, Rusell JW, et al. A strategy for primary reconstruction of long gap esophageal atresia using neonatal colon esophagoplasty: a case report. J Pediatr Surg 1999;34:75-78.
14. Connolly B, Guiney EJ. Trends in tracheoesophageal fistula. Surg Gynecol Obstet 1987;164:308-312.
15. Poenaru D, Laberge JM, Neilson RI. A New prognostic classification for esophageal atresia. Surgery 1993;113:426-432.
16. Teich S, Barton DP, Ginn-Pease ME, et al. Prognostic classification for esophageal atresia and tracheoesophageal fistula: Waterston versus Montreal. J Pediatr Surg 1997;32:1075-1080.
17. Randolph GJ, Newman DK, Anderson K. Current results repair of esophageal atresia with tracheoesophageal fistula using physiologic status as a guide to therapy. Ann Surg 1989;209:526-531.
18. McKinnon, Kosloske MA. Prediction and prevention of anastomotic complications of esophageal atresia and tracheoesophageal fistula. J Pediatr Surg 1990;25:778-781.
19. Canty TG, Boyle EM, Linden B, et al. Aortic arch anomalies associated with long gap esophageal atresia and tracheoesophageal fistula. J Pediatr Surg 1997;32:1587-1591.
20. Spitz L, Kiely E, Brereton RJ. Esophageal atresia: five-year experience with 148 cases. J Pediatr Surg 1987;22:103-108.
21. Filston HC, Rankin JS, Grimm JK. Esophageal atresia. Prognostic factors and contribution of preoperative telescopic endoscopy. Ann Surg 1984;199:532-537.
22. Saing H, Mya G, Cheng W. The involvement of two or more systems and the severity of associated anomalies significantly influence mortality in esophageal atresia. J Pediatr Surg 1998;33:1596-1597.
23. Koop CE, Chnaufer L, Broennie M. Esophageal atresia and tracheo-
esophageal fistula: Supportive measures that affect survival. Pediatrics 1974;54:558-564.
24. Choudhury SR, Aschcraft WK, Sharp RJ, et al. Survival of patients with esophageal atresia: influence of birth weight, cardiac ano-
maly and late respiratory complications. J Pediatr Surg 1999;
25. Engum SA, Grosfeld JL, West KW, et al. Analysis of morbidity and mortality of 227 cases of esophageal atresia and/or tracheo-
esophageal fistula over two decades. Arch Surg 1995; 130: