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Published on: April 17, 2020
Comorbidities and course of lung function in patients with congenital esophageal atresia
Ana Jové Blanco1, Ana Gutiérrez Vélez1, Gonzalo Solís-García1
1Department of Pediatric Pulmonology, Hospital General Universitario Gregorio Maranon, Madrid, Spain.
Insights
Patients with esophageal atresia surgery often develop respiratory and gastrointestinal issues. Lung function tends to decline over time, highlighting the need for ongoing monitoring and management.
Area of Science:
- Pediatric Surgery
- Pulmonology
- Epidemiology
Background:
- Esophageal atresia (EA) is a congenital condition requiring surgical intervention.
- Long-term outcomes, particularly respiratory function, are critical for affected individuals.
Purpose of the Study:
- To analyze the epidemiological features, clinical course, and pulmonary function in patients post-esophageal atresia surgery.
- To identify risk factors for respiratory complications in this population.
Main Methods:
- A retrospective, longitudinal study reviewed medical records of 97 EA patients (1996-2017).
- Data included perinatal factors, atresia type, comorbidities, respiratory/gastrointestinal complications, and serial spirometry over 3 years.
Main Results:
- Type III EA and trisomy 21 were most common. Neonatal mortality was 13.4%.
- Respiratory issues included exacerbations (46.4%), wheezing/asthma (36%), and pneumonia (26.8%).
- Gastroesophageal reflux was a significant risk factor for respiratory complications. Spirometry showed a trend towards worsening lung function over time.
Conclusions:
- A substantial percentage of patients with esophageal atresia experience significant respiratory and gastrointestinal comorbidities.
- Progressive decline in lung function is observed, underscoring the importance of long-term respiratory care.
Objective:
To describe the epidemiological characteristics, hospital follow-up, and course of patients who underwent surgery for esophageal atresia and its consequences on lung function.
Population And Methods:
Retrospective, longitudinal, and analytical study. The medical records of patients with esophageal atresia born between 1996 and 2017 were reviewed. Perinatal data, type of atresia, associated malformations, respiratory and gastrointestinal complications, and spirometry data were recorded over 3 years.
Results:
A total of 97 patients were included. The most common type of atresia was III, and the most frequent syndrome, trisomy 21; 13.4 % of patients died in the neonatal period; 23.8 % were followed up by the Department of Pulmonology, and their respiratory complications included exacerbations (46.4 %), wheezing or asthma (36 %), and pneumonia (26.8 %). Gastroesophageal reflux was a risk factor for wheezing (OR: 5.31; p = 0.002), exacerbations (OR: 4.00; p=0.009), and pneumonia (OR: 3.24; p = 0.02). In the first spirometry (n=20), the pattern was normal in 65 %; restrictive in 30 %; and mixed in 5 %. In the second spirometry (n = 19), the pattern was normal in 42.1 %; restrictive in 31.6 %; obstructive in 15.8 %, and mixed in 10.5 %. In the third spirometry (n = 14), the pattern was normal in 50 %; restrictive in 21.4 %; obstructive in 14.3 %, and mixed in 14.3 %.
Conclusions:
In our sample of patients, a large proportion had respiratory and gastrointestinal comorbidities. Lung function worsened progressively.
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