RT Journal Article
SR Electronic
T1 Predictors of poor outcomes in children with tracheoesophageal fistula/oesophageal atresia: an Australian experience
JF World Journal of Pediatric Surgery
JO World Jnl Ped Surgery
FD BMJ Publishing Group Ltd
SP e000190
DO 10.1136/wjps-2020-000190
VO 4
IS 2
A1 Hew, Nicole Lee Chui
A1 Grover, Zubin
A1 Paida, Sanjay
A1 Gera, Sanchita
A1 Effendy, Rachel Zie Ting
A1 Kikiros, Colin
A1 Gera, Parshotam
YR 2021
UL http://wjps.bmj.com/content/4/2/e000190.abstract
AB Objective The aim of this study is to characterize long-term morbidities of oesophageal atresia (OA) with or without tracheoesophageal fistula (TOF).Methods Infants born with OA/TOF from 2000 to 2016 in Western Australia were included for analysis. Infants were categorized into high-risk and low-risk groups based on the presence of one or more perioperative risk factors [low birth weight, vertebraldefects, anal atresia, cardiac defects, TOF, renalanomalies, limb abnormalities (VACTERL), anastomotic leak, long gap OA, and failure to establish oral feeds within the first month] identified by a previous Canadian study. Frequency of morbidities in infants with perioperative risk factors was compared.Results Of 102 patients, 88 (86%) had OA with distal TOF (type C). The most common morbidities in our cohort were anastomotic oesophageal strictures (AS) (n=53, 52%), tracheomalacia (n=48, 47%), gastroesophageal reflux disease (GORD) (n=42, 41%) and recurrent respiratory tract infections (n=40, 39%). Presence of GORD (30/59 vs 12/43, p=0.04) and median frequency of AS dilatations (8 vs 3, n=59, p=0.03) were greater in the high-risk group. This study further confirmed that inability to be fed orally within the first month was associated with high morbidities.Conclusions Gastrointestinal and respiratory morbidities remain high in OA/TOF regardless of perioperative risk factors. Inability to be fed orally within the first month is a predictor of poor outcomes with high frequency of gastrointestinal and respiratory comorbidities.All data relevant to the study are included in the article or uploaded as supplementary information.