Outcomes in esophageal atresia and tracheoesophageal fistula

被引:132
作者
Konkin, DE [1 ]
O'Hali, WA [1 ]
Webber, EM [1 ]
Blair, GK [1 ]
机构
[1] Univ British Columbia, British Columbia Childrens Hosp, Dept Surg, Vancouver, BC V5Z 1M9, Canada
关键词
esophageal atresia; tracheoesophageal fistula; gastroesophageal reflux;
D O I
10.1016/j.jpedsurg.2003.08.039
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background/Purpose: The purpose of this analysis was to investigate outcomes in newborns with esophageal atresia (EA) or tracheoesophageal fistula (TEF) with respect to prognostic classifications and complications. Methods: Charts of all 144 infants with EA/TEF treated at British Columbia Children's Hospital (BCCH) from 1984 to 2000 were reviewed. Patient demographics, frequency of associated anomalies, and details of management and outcomes were examined. Results: Applying the Waterston prognostic classification to our patient population, survival rate was 100% for class A, 100% for class B, and 80% for class C. The Montreal classification survival rate was 92% for class I and 71% for class II (P =.08). Using the Spitz classification, survival rate was 99% for type I, 84% for type II, and 43% for type III (P <.05). The Bremen classification survival rate was 95% "without complications" and 71% "with complications." Complications included stricture (52%), gastroesophageal reflux (31%), anastomotic leakage (8%), recurrent fistula (8%), and pneumonia (6%). Seventeen patients underwent fundoplication for gastroesophageal reflux, 16 pre-1992 and one post-1992. Conclusions: Comparing the major prognostic classifications, the Spitz classification scheme was found to be most applicable. In our institution, the trend in management of gastroesophageal reflux after repair of EA/TEF has moved away from fundoplication toward medical management.
引用
收藏
页码:1726 / 1729
页数:4
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