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Esophageal atresia: mortality and complications related to gastroesophageal reflux
1Department of Pediatric Surgery, Karolinska Institute, St Göran's Hospital, Stockholm, Sweden.
Insights
Gastroesophageal reflux is a significant risk in esophageal atresia patients, causing serious complications and late deaths from aspiration. Early identification and management of reflux are crucial for improving outcomes and reducing mortality in these vulnerable infants.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Neonatology
Background:
- Low birthweight and congenital anomalies are key risk factors in esophageal atresia (EA).
- Gastroesophageal reflux (GER) is a frequent complication in EA patients, potentially leading to severe health issues.
Purpose of the Study:
- To retrospectively analyze complications and mortality in 110 EA patients treated between 1971-1987.
- To investigate the role of gastroesophageal reflux in EA patient outcomes.
Main Methods:
- Retrospective analysis of 110 patients with esophageal atresia.
- Review of treatment records from January 1971 to December 1987.
- Assessment of complications, mortality, and the impact of reflux symptoms.
Main Results:
- Overall mortality was 12% (13/110).
- Early mortality was linked to prematurity and anomalies; late mortality often resulted from aspiration.
- Reflux symptoms were common, with severe cases causing aspiration-related deaths.
Conclusions:
- Early identification of gastroesophageal reflux is vital for preventing severe complications and mortality in esophageal atresia.
- Reflux management is critical for improving long-term outcomes in EA patients.
- Circular myotomy did not increase mortality despite higher complication rates.
Abstract:
Low birthweight and associated anomalies are important risk factors in patients with esophageal atresia. Gastroesophageal reflux is also a common problem in these patients and can lead to serious complications. The aim of this retrospective study was to analyse complications and mortality in 110 patients treated for esophageal atresia between January 1971-December 1987, in order to determine what role reflux may play. Symptoms of reflux were common in most patients during the first years of life. In some cases the symptoms were serious and even caused some late deaths by aspiration. The overall mortality was 12% (13/110). Early mortality (six patients) was caused by prematurity and associated anomalies, whereas late mortality often was caused by aspiration or other respiratory complications. Patients who had been operated with a circular myotomy showed more complications, but did not show a higher mortality rate than the remainder. This study confirms the importance of identifying patients with reflux at an early stage in order to prevent serious complications and mortality.