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Aerodigestive Clinic: Multidisciplinary Follow Up for Oesophageal Atresia and Tracheoesophageal Fistula Patients
Annabel Kate Noakes1, James Hamill1, Edward Toll1
1Starship Hospital, Te Whatu Ora Te Toka Tumai, Auckland, New Zealand.
Insights
Children with oesophageal atresia and tracheoesophageal fistula (OA/TOF) need extensive follow-up care. A coordinated multidisciplinary aerodigestive clinic helps manage these complex long-term aerodigestive issues effectively.
Area of Science:
- Pediatric Surgery
- Neonatal Congenital Conditions
- Aerodigestive Tract Disorders
Background:
- Oesophageal atresia and tracheoesophageal fistula (OA/TOF) is a common neonatal congenital anomaly requiring surgical repair.
- Patients with OA/TOF often experience persistent aerodigestive problems post-repair.
- Ongoing multidisciplinary care is crucial for managing long-term complications.
Purpose of the Study:
- To evaluate the benefits of a coordinated multidisciplinary aerodigestive follow-up clinic for OA/TOF patients.
- To assess the impact of specialized care on managing complex aerodigestive issues in this population.
Main Methods:
- Retrospective cohort study of OA/TOF repair patients (2008-2022).
- Data collected from Paediatric Surgery, Otorhinolaryngology (ORL), Gastroenterology, Respiratory, Dietetics, and Speech Language Therapy (SLT).
- Analysis categorized by clinic visits, investigations, and operative procedures.
Main Results:
- 79 OA/TOF patients included in the analysis; median hospital stay was 27 days.
- In the first year, patients averaged 5.8 clinic visits, 0.8 investigations, and 1.9 operative procedures.
- 19% of patients had rural addresses, highlighting potential access barriers to care.
Conclusions:
- OA/TOF patients require significant and varied follow-up care post-repair.
- A multidisciplinary aerodigestive clinic demonstrates clear benefits for managing these complex cases.
- Further review of data post-multidisciplinary clinic establishment is planned.
Aims:
Oesophageal atresia and tracheoesophageal fistula (OA/TOF) is a neonatal congenital condition usually repaired within the first days of life. Children with OA/TOF frequently experience long-term aerodigestive tract difficulties, requiring ongoing multidisciplinary care from a variety of different specialties and allied health services. Our aim was to determine the benefit of a coordinated multidisciplinary Aerodigestive follow up clinic for patients with OA/TOF.
Methods:
We conducted a retrospective cohort study of all patients who underwent OA/TOF repair at Starship Hospital between 2008 and 2022. Follow up data was collected from Paediatric Surgery, Paediatric Otorhinolaryngology (ORL), Gastroenterology, Respiratory, Dietetics and Speech Language Therapy (SLT), and was categorised according to clinics, investigations and operative visits.
Results:
Ninety three patients were identified as having OA/TOF repairs during the study timeframe, and 79 were included in the analysis. The median length of hospital stay from birth to discharge was 27 days. During the first year of life, patients had an average of 5.8 clinic visits (range 0-33), 0.8 diagnostic investigations (range 0-4), and 1.9 operative procedures (range 0-17). The mean age at the end of the follow up period was 6.45 years. 19% of included patients had a rural address, indicating greater difficulty in accessing care due to location.
Conclusion:
Our results highlight the significant and diverse follow up care that OA/TOF patients require following repair, and the benefit of a multidisciplinary Aerodigestive follow up clinic. A review of data following the establishment of a multidisciplinary clinic at Starship Hospital is planned.
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