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Surgical repair of long-gap esophageal atresia: A retrospective study comparing the management of long-gap esophageal atresia in the Nordic countries

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  • Tatjana Stadil
  • Antti Koivusalo
  • Mikko Pakarinen
  • Audun Mikkelsen
  • Ragnhild Emblem
  • Jan F Svensson
  • Henrik Ehrén
  • Linus Jönsson
  • Jakob Bäckstrand
  • Helene Engstrand Lilja
  • Felipe Donoso
  • Jørgen Mogens Thorup
  • Thorstein Sæter
  • Lars Rasmussen
  • Rikke Neess Pedersen
  • Pernilla Stenström
  • Einar Arnbjörnsson
  • Kristján Óskarsson
  • Niels Qvist
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BACKGROUND: Several surgical procedures have been described in the reconstruction of long-gap esophageal atresia (LGEA). We reviewed the surgical methods used in children with LGEA in the Nordic countries over a 15-year period and the postoperative complications within the first postoperative year.

METHODS: Retrospective multicenter medical record review of all children born with Gross type A or B esophageal atresia between 01/01/2000 and 12/31/2014 reconstructed within their first year of life.

RESULTS: We included 71 children; 56 had Gross type A and 15 type B LGEA. Delayed primary anastomosis (DPA) was performed in 52.1% and an esophageal replacement procedure in 47.9%. Gastric pull-up (GPU) was the most frequent procedure (25.4%). The frequency of chromosomal abnormalities, congenital heart defects and other anomalies was significantly higher in patients who had a replacement procedure. The frequency of gastroesophageal reflux (GER) was significantly higher after DPA compared to esophageal replacement (p = 0.013). At 1-year follow-up the mean body weight was higher after DPA than after organ interposition (p = 0.043).

CONCLUSION: DPA and esophageal replacement procedures were equally applied. Postoperative complications and follow-up were similar except for the development of GER and the body weight at 1-year follow-up. Long-term results should be investigated.

TYPE OF STUDY: Treatment study.

LEVEL OF EVIDENCE: Level III.

Original languageEnglish
JournalJournal of Pediatric Surgery
Volume54
Issue number3
Pages (from-to)423-428
Number of pages6
ISSN0022-3468
DOIs
Publication statusPublished - Mar 2019

    Research areas

  • Esophageal atresia, Gross type A, Gross type B, Long gap, Postoperative complication, Surgical repair, Anastomosis, Surgical/adverse effects, Humans, Infant, Treatment Outcome, Scandinavian and Nordic Countries, Esophagoplasty/adverse effects, Postoperative Complications/epidemiology, Esophagus/surgery, Retrospective Studies, Replantation/statistics & numerical data, Esophageal Atresia/surgery, Infant, Newborn

ID: 56504075