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Growth assessments for children with recurrent tracheoesophageal fistulas
Peize Wang1, Shen Yang1, Kaiyun Hua1
1Department of Neonatal Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
Insights
Growth retardation is common after recurrent tracheoesophageal fistula repair. Lower birth weight, anastomotic stricture, and dysphagia are key risk factors for impaired growth in these children.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Growth and Development
Background:
- Recurrent tracheoesophageal fistula (rTEF) presents significant challenges in pediatric surgical care.
- Assessing growth status and identifying risk factors for growth retardation (GR) is crucial for optimizing outcomes in these patients.
Purpose of the Study:
- To evaluate the growth status of children treated for recurrent tracheoesophageal fistula (rTEF).
- To identify independent risk factors associated with growth retardation (GR) following rTEF repair.
Main Methods:
- Retrospective analysis of medical records for 83 patients who underwent surgical repair for rTEF.
- Comparison of clinical variables between groups with and without growth retardation (GR).
- Univariate and multivariable logistic regression to determine risk factors for GR.
Main Results:
- Growth retardation (GR) was observed in 33.7% of 83 children post-rTEF repair after a median follow-up of 31.4 months.
- Multivariate analysis identified lower birth weight (OR 0.325), anastomotic stricture (OR 4.396), and post-repair dysphagia (OR 5.341) as independent risk factors for GR.
Conclusions:
- Growth retardation (GR) is a frequent complication following surgical repair of recurrent tracheoesophageal fistula (rTEF).
- Key independent risk factors for GR include lower birth weight, anastomotic stricture, and dysphagia.
Purpose:
To assess the growth status of children with recurrent tracheoesophageal fistula (rTEF), and determine the possible risk factors of growth retardation (GR).
Methods:
The medical records of 83 patients with rTEF who underwent surgical repair were retrospectively analyzed. The patients were retrospectively divided into two groups according to whether they had GR. The clinical variables were compared between the GR and non-GR groups. Univariate and multivariable logistic regression analysis were performed to identify the risk factors for GR.
Results:
Eighty-three children diagnosed with rTEF were included in this study. After a median follow-up of 31.4 (19.8, 48.7) months, GR occurred in 28 patients (33.7%). Among them, six patients with only weight for age Z score (WAZ) < -2SD, five patients with only height for age Z score (HAZ) < -2SD, and six patients with only BMI for age Z score (BAZ) < -2SD, while seven patients with both WAZ and HAZ < -2SD and four patients with both WAZ, HAZ and BAZ < -2SD. Multivariate logistic regression analysis showed that birth weight, anastomotic stricture and dysphagia after rTEF repair were independent risk factors with OR of 0.325 (0.119, 0.891), 4.396 (1.451, 13.324) and 5.341 (1.153, 24.752) for GR, respectively.
Conclusions:
GR is a common complication after rTEF repair. Birth weight, anastomotic stricture and dysphagia after rTEF repair are independent risk factors affecting growth.
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