Postoperative reintubation as risk factor for anastomotic stricture after congenital esophageal atresia

To examine the consequences of preoperative invasive ventilation (IV), postoperative IV and reintubation on the occurrence of ES in type C CEA patients.

This retrospective study collected the data from patients diagnosed as Gross type C CEA and underwent surgical repair at our institution between January 2013 and December 2022. Comprehensive data, including demographic characteristics, preoperative comorbidities, perioperative indicators, and postoperative outcomes were collected and analyzed. We performed univariate analysis followed by multivariate binary logistic regression analysis to clarify the effect of IV on ES.

Among the 250 infants included in this study, 35 cases (14.0%) developed ES. Operative duration was significantly longer in ES cases (median: 127 vs 106 min, P = 0.007). Postoperative invasive ventilation (82.9% vs 61.4%, P = 0.014), reintubation (40.0% vs 11.2%; P = 0.001), anastomotic leakage (34.3% vs 17.7%, P = 0.023), and prolonged hospitalization (median: 35 vs 24 days, P = 0.003) were more frequent in ES infants. Multivariable analysis confirmed postoperative reintubation (adjusted OR = 3.497, P = 0.007) as independent risk factors for ES.

Postoperative reintubation was an independent risk factor for ES following type C CEA repair. To reduce the need for reintubation, individualized respiratory support strategies were recommended.