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Preoperative home care for esophageal atresia--a survey

C M Hollands1, C A Lankau, C A Burnweit

  • 1Miami Children's Hospital, Division of Pediatric Surgery, FL, USA.

Journal of Pediatric Surgery
|February 29, 2000
PubMed

Insights

Pediatric surgeons report varied experiences with home care for long gap esophageal atresia. Most patients managed at home experienced no complications, suggesting a safe and cost-effective approach.

Area of Science:

  • Pediatric Surgery
  • Neonatal Care
  • Surgical Outcomes

Background:

  • Long gap esophageal atresia necessitates prolonged preoperative management.
  • A lack of established protocols for preoperative home care was identified.
  • This study addresses the need for understanding current practices in home care for these patients.

Purpose of the Study:

  • To survey pediatric surgeons' experiences with preoperative home care for long gap esophageal atresia.
  • To identify current practices, challenges, and outcomes associated with home management.
  • To assess the feasibility and safety of preoperative home care.

Main Methods:

  • A survey was distributed to 543 pediatric surgeons regarding home care for long gap esophageal atresia.
  • Data collected included the number of patients treated at home, nursing care details, insurance issues, and complications.
  • Responses from 380 surgeons (70% return rate) were analyzed, with 165 surveys detailing 348 patients.

Main Results:

  • 25% of surgeons (41/165) reported managing 72% of eligible patients (63/87) at home.
  • Home nursing care was utilized for 70% of patients, with varied schedules (night, day, 24-hour, intermittent).
  • No complications directly attributed to preoperative home care were reported.

Conclusions:

  • Significant variation and hesitancy exist among surgeons regarding preoperative home care for long gap esophageal atresia.
  • Many surgeons find the technique safe and cost-effective.
  • A prospective, multicenter, randomized controlled trial is recommended to further evaluate this management strategy.
Abstract

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