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A different approach to leakage of esophageal atresia in children
Erol Basuguy1, Mehmet Hanifi Okur1, Serkan Arslan1
1Department of Pediatric Surgery, Dicle University Faculty of Medicine, Diyarbakır-Turkey.
Insights
This study shows that using a nasojejunal catheter is an effective conservative treatment for esophageal leakage after surgery for esophageal atresia and tracheoesophageal fistula (EA/TEF). This method reduces complications and allows for earlier feeding.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Esophageal leakage is a complication following surgery for esophageal atresia and tracheoesophageal fistula (EA/TEF).
- Traditional treatments may lead to complications and delayed feeding.
Purpose of the Study:
- To evaluate a conservative treatment approach for esophageal leakage using a nasojejunal catheter.
- To assess the efficacy of this method in reducing complications and enabling earlier feeding.
Main Methods:
- Retrospective review of 98 patients with EA/TEF treated between February 2013 and January 2018.
- Esophageal leakage was managed by converting a nasogastric catheter to a nasojejunal catheter under fluoroscopic guidance for continued feeding.
Main Results:
- 18.3% of patients (18/98) experienced anastomotic leakage.
- Average recovery time was 21.1 days; 8 patients developed stenosis, successfully treated with dilatation.
- The nasojejunal catheter approach facilitated feeding in patients with leakage.
Conclusions:
- The described conservative treatment using a nasojejunal catheter is effective for esophageal leakage post-EA/TEF repair.
- This approach may reduce complications, allow for earlier feeding, and lower treatment costs compared to alternative methods.
Background:
In this study, we aimed to present the results of patients treated for esophageal leakage with a different conservative approach.
Methods:
Ninety-eight patients with esophageal atresia and tracheoesophageal fistula (EA) who underwent surgery in our clinic between February 2013 and January 2018 were retrospectively reviewed in this study. Patients' anastomosis leakage, gestational week, gender, body weight, referral date, recovery time and stenosis were recorded. After leakage detection, the nasogastric catheter was fluoroscopically converted into a nasojejunal catheter using a guidewire and feeding continued.
Results:
Anastomotic leakage developed in 18 (18.3%) patients. The average gestational age at birth was 35.4 weeks; the patients included ten girls and eight boys of average weight 2.41 kg; the average referral period was 2.1 days after birth and the average time of surgery was 2.4 days after birth. The average recovery time was 21.1 days (range: 8-60 days). Eight patients developed stenosis that recovered with dilatation.
Conclusion:
Our findings suggest that our conservative treatment approach, which uses a nasojejunal catheter, is an effective method that would reduce complications, enable earlier feeding, and reduce the cost compared to other treatment approaches.
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