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Congenital anomalies associated with esophageal atresia: Saudi experience
1King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Insights
Survival rates for newborns with esophageal atresia/tracheoesophageal fistula (EA/TEF) are high, particularly without other congenital anomalies. Associated genitourinary and cardiovascular issues warrant investigation in EA/TEF patients.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Congenital Malformations
Background:
- Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a complex congenital condition requiring specialized management.
- Understanding the impact of associated anomalies on survival is crucial for optimizing patient outcomes.
Purpose of the Study:
- To analyze the survival rates of Saudi newborns diagnosed with EA/TEF.
- To identify the types and prevalence of congenital anomalies associated with EA/TEF.
- To determine the influence of these anomalies on patient survival.
Main Methods:
- Retrospective review of 89 Saudi newborns with EA/TEF managed between 1980-1995.
- Data collection included patient demographics, presence of associated congenital anomalies, and survival status.
- Statistical analysis compared survival rates based on the presence and type of anomalies.
Main Results:
- The overall survival rate for EA/TEF newborns was high (93% without anomalies vs. 77% with anomalies, p=0.028).
- Genitourinary (21%) and cardiovascular (19%) anomalies were most common.
- Patients with chromosomal anomalies had 0% survival, while those with head and neck anomalies had 100% survival.
Conclusions:
- Newborns with EA/TEF have a high survival rate, significantly improved by the absence of associated congenital anomalies.
- Routine investigation for genitourinary and cardiovascular anomalies is recommended for all EA/TEF patients.
- While most anomalies did not significantly alter survival, chromosomal anomalies were universally fatal.
Abstract:
Eighty-nine Saudi newborns with esophageal atresia/tracheoesophageal fistula (EA/TEF) were managed at King Faisal Specialist Hospital and Research Center (KFSH & RC), Riyadh, Saudi Arabia between the years 1980-1995; there were 54 boys and 35 girls. Forty-four (49%) newborns had associated congenital anomalies. Genitourinary anomalies were present in 19 (21%), cardiovascular in 17 (19%), gastrointestinal in 9 (10%), central nervous system in 8 (9%), musculoskeletal in 7 (8%), chromosomal anomalies in 4 (5%), and head and neck in 5 (6%) cases. In general, the survival rate was higher in patients without associated anomalies than with associated anomalies (93 vs. 77%, p = 0.028). However, all patients with head and neck anomalies survived, whereas all patients with chromosomal anomalies died. With these exceptions, the survival rate was similar regardless of the type or the number of associated anomalies. The average birth weight was similar between survivors and non-survivors (2572 vs. 2376 g) and between patients with or without associated anomalies (2566 vs. 2519 g). We conclude that the survival rate of newborns with EA/TEF is high, especially in the absence of associated anomalies. Investigations for possible associated genitourinary and cardiovascular anomalies should be considered for all patients with EA/TEF.