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Esophageal atresia in infants with very low birth weight
1Children's Healthcare of Atlanta at Egleston and Emory Children's Center, Georgia, USA.
Insights
Very low birth weight (VLBW) infants with esophageal atresia (EA) and tracheoesophageal fistula (TEF) have improved survival rates. Current therapy allows for primary or delayed primary anastomosis based on patient stability, moving away from automatic staging.
Area of Science:
- Neonatal surgery
- Pediatric gastroenterology
- Congenital anomalies
Background:
- Esophageal atresia (EA), often with tracheoesophageal fistula (TEF), is commonly associated with low birth weight.
- Advances in neonatal care have increased survival rates for very low birth weight (VLBW) infants (birth weight < 1.5 kg).
Purpose of the Study:
- To review the epidemiology, pathophysiology, treatment, and prognosis of EA in VLBW infants.
- To present the authors' experience and review global literature on managing VLBW infants with EA.
Main Methods:
- Literature review of EA and TEF in VLBW infants.
- Analysis of clinical case experience with VLBW infants diagnosed with EA.
Main Results:
- VLBW infants with EA/TEF are increasingly surviving due to improved neonatal, respiratory, surgical, and anesthetic care.
- Therapy for VLBW neonates with EA is no longer automatically staged.
- Primary or delayed primary anastomosis is now safely feasible for stable VLBW patients.
Conclusions:
- Management strategies for EA in VLBW infants have evolved, allowing for more individualized treatment approaches.
- Improved survival rates highlight the importance of specialized care for VLBW infants with EA/TEF.
Abstract:
Infants with esophageal atresia (EA), with or without a tracheoesophageal fistula (TEF) frequently are of low birth weight. With advances in neonatal, respiratory, surgical, and anesthetic care, more infants with very low birth weight (VLBW; birth weight less than 1.5 kg) are surviving. The therapy of the VLBW neonate with EA is not longer automatically staged. Primary or delayed primary anastomosis can be performed safely if the patient is stable. This report will review the epidemiology, pathophysiology, treatment, and prognosis of EA in VLBW infants. The authors present their own experience in dealing with the VLBW with EA and review the world literature.