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Predictive factors affecting the prognosis and late complications of 73 consecutive cases of esophageal atresia at 2 centers

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Abstract

Purpose

While the diagnosis and outcomes of esophageal atresia (EA) have improved, associated anomalies, the management of late complications and growth remain major issues. We analyzed factors that affected the prognosis, late complications and growth.

Methods

We retrospectively reviewed EA patients treated at two centers from 1984 to 2016. Patient characteristics, complications (gastroesophageal reflux [GER], anastomotic stenosis, tracheomalacia, dysphagia) and growth were evaluated.

Results

Seventy-three EA patients were treated (overall survival rate:80.8%). The mean birth weight was 2514 ± 509 g in the surviving group, and 2453 ± 567 g in the fatal group excluded chromosomal abnormality (p = 0.76). Cardiac and chromosomal anomalies significantly affected mortality. Postoperative GER and anastomotic stenosis each occurred in 39% of the patients. Only GER was significantly affected by the Gross classification. The standard deviation (SD) values of the EA patients’ growth were all lower than in the normal population. The SD of body weight was significantly lower in patients with extremity anomalies.

Conclusions

Associated cardiac and chromosomal anomalies significantly affected the prognosis. GER and anastomotic stenosis were the most common late complications. The growth of the surviving cases was insufficient. These factors will help optimize the therapeutic strategies and postoperative management for EA.

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Acknowledgements

We thank Mr. Brian Quinn for his comments and help with the manuscript. This study was supported by a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (JSPS, Nos. 26670765, 16K10466, 16K10094, 16K10095, 16K10434, 16H07090, 17K10555, 17K11514, 17K10183, 17K11515), a research grant from the President’s Discretionary Expenses of our university, and a research grant from The UBE Foundation.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan

    Ryuta Masuya, Tatsuru Kaji, Motoi Mukai, Kazuhiko Nakame, Takafumi Kawano, Seiro Machigashira, Waka Yamada, Koji Yamada, Shun Onishi, Keisuke Yano, Tomoe Moriguchi, Koshiro Sugita, Masato Kawano & Satoshi Ieiri

  2. Department of Pediatric Surgery, Kagoshima City Hospital, Kagoshima, Japan

    Hiroyuki Noguchi, Masaya Suzuhigashi & Mitsuru Muto

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  1. Ryuta Masuya
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  2. Tatsuru Kaji
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  14. Hiroyuki Noguchi
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  15. Masaya Suzuhigashi
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  16. Mitsuru Muto
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  17. Satoshi Ieiri
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Corresponding author

Correspondence to Satoshi Ieiri.

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The authors declare no conflicts of interest in association with the present study.

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Masuya, R., Kaji, T., Mukai, M. et al. Predictive factors affecting the prognosis and late complications of 73 consecutive cases of esophageal atresia at 2 centers. Pediatr Surg Int 34, 1027–1033 (2018). https://doi.org/10.1007/s00383-018-4326-1

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  • DOI: https://doi.org/10.1007/s00383-018-4326-1

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