Oesophageal atresia: a 10-year experience of a Paediatric Intensive Care Unit
Keywords:Complications, oesophageal atresia, outcome, surgery
Background/Purpose: Oesophageal atresia (OA) is a congenital malformation with a variable prognosis. The aims were to establish OA’s incidence in the central region, to characterize infants with OA admitted and to compare its clinical outcome after surgical repair, according to OA classifi cation.
Methods: A retrospective review of infants with OA admitted to a PICU, after surgical repair, between 2002 and 2011. Patient characteristics, OA’s classifi cation, surgery, morbidity and mortality were analyzed. Two groups were compared according to OA classifi cation.
Results: Thirty-four infants were admitted, out of which 65% were male, with a median gestational age of 36 weeks and birth weight of 2310g. Nineteen of them presented other malformations, mainly cardiac. Nine cases were classifi ed as long-gap OA. Fistula ligation and primary oesophageal anastomosis was the most common surgical option (n=27). Early complications occurred in 13 infants (38%), mostly anastomotic leak, and were similar according to gap length (p=0.704). PICU stay and mechanical ventilation were longer in long-gap OA patients (p=0.009 and p<0.001 respectively) and in infants with other malformations (p=0.027 and p=0.003 respectively). There was no mortality.
Conclusions: The frequency of OA associated malformations implies a systematic screening of these patients. Gap length and presence of associated malformations were the major determinants of length of intensive care stay and ventilation days in OA patients.
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