Advertisement

Long-term analysis of children with esophageal atresia and tracheoesophageal fistula

      Abstract

      Background/purpose

      For children with esophageal atresia (EA) or tracheoesophageal fistula (TEF), the first years of life can be associated with many problems. Little is known about the long-term function of children who underwent repair as neonates. This study evaluates outcome and late sequelae of children with EA/TEF.

      Methods

      Medical records of infants with esophageal anomalies (May 1972 through December 1990) were reviewed. Study parameters included demographics, dysphagia, frequent respiratory infections (> 3/yr), gastroesophageal reflux disease (GERD), frequent choking, leak, stricture, and developmental delays (weight, height < 25%, < 5%, respectively).

      Results

      Over 224 months, 69 infants (37 boys, 32 girls) were identified: type A, 10 infants; type B, 1; type C, 53; type D, 4; type E, 1. Mean follow-up was 125 months. During the first 5 years of follow-up, dysphagia (45%), respiratory infections (29%), and GERD (48%) were common as were growth delays. These problems improved as the children matured.

      Conclusions

      Children with esophageal anomalies face many difficulties during initial repair and frequently encounter problems years later. Support groups can foster child development and alleviate parent isolationism. Despite growth retardation, esophageal motility disorders, and frequent respiratory infections, children with EA/TEF continue to have a favorable long-term outcome.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Pediatric Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Haight C.
        • Towslet H.
        Congenital atresia of the oesophagus with tracheo-osophageal fistula.
        Surg Gynecol Obstet. 1943; 76: 672-688
        • Myers N.A.
        Osophageal atresia.
        Ann R Coll Surg Engl. 1974; 54: 277-287
        • Lindahl H.
        Esofagusatresia ja trakeosofageaalinen fisteli.
        Thesis. Helsinki University, Helsinki1984
        • Engum S.A.
        • Grosfeld J.L.
        • West K.W.
        • et al.
        Analysis of morbidity and mortality in 227 cases of esophageal atresia and/or tracheoesophageal fistula over two decades.
        Arch Surg. 1995; 130: 502-508
        • Luzzatto C.
        • Ronconi M.
        • Turra S.
        • et al.
        Long-term follow-up after surgical repair of esophageal atresia.
        Padiatrie und Padologie. 1990; 25: 313-320
        • Parker A.F.
        • Christie D.L.
        • Cahill J.L.
        Incidence and significance of gastroesophageal reflux following repair of esophageal atresia and tracheoesophageal fistula and the need for antireflux procedures.
        J Pediatr Surg. 1979; 14: 5-8
        • Shermeta D.W.
        • Whitington P.F.
        • Seto D.S.
        • et al.
        Lower esophageal sphincter dysfunction in esophageal atresia. Nocturnal regurgitation and aspiration pneumonia.
        J Pediatr Surg. 1977; 12: 871-876
        • Koch A.
        • Rohr S.
        • Plaschkes J.
        • et al.
        Incidence of gastroesophageal reflux following repair of esophageal atresia.
        Prog Pediatr Surg. 1986; 19: 103-113
        • Fonkalsrud E.W.
        Gastroesophageal fundoplication for reflux following repair of esophageal atresia.
        Arch Surg. 1979; 114: 48-51
        • Gauthier F.
        • Gandiche O.
        • Baux D.
        • et al.
        Atresie de Iaesophage et reflux gastroaesophagien.
        Chir Pediatric. 1980; 21: 254-256
        • Dal la Vecchia L.K.
        • Grosfeld J.L.
        • West K.W.
        Reoperation after Nissen fundoplication in children with gastroesophageal reflux.
        Ann Surg. 1997; 226: 315-323
        • Schier F.
        • Korn S.
        • Michel E.
        Experiences of a parent support group with the long-term consequences of esophageal atresia.
        J Pediatr Surg. 2001; 36: 605-610
        • Somppi E.
        • Tammela O.
        • Ruuska T.
        • et al.
        Outcome of patients operated on for esophageal atresia.
        J Pediatr Surg. 1998; 33: 1341-1346
      1. www.eatef.org. EA/TEF Child and Family Support Connection, Inc. 111 West Jackson Blvd, Suite 1145, Chicago, IL 60604-3502

      2. www.tofs.org.uk. St George’s Centre, 91 Victoria Rd, Netherfield Nottingham NG4 2NN, July 29, 1999

      Further reading

      Discussion