Surgical repair of long-gap esophageal atresia

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

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*

*Corresponding author for this work

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Abstract

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
ISSN0022-3468
DOIs
Publication statusPublished - Mar 2019

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Scandinavian and Nordic Countries
Esophageal Atresia
Retrospective Studies
Gastroesophageal Reflux
Medical Records

Keywords

  • 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

Cite this

Stadil, Tatjana ; Koivusalo, Antti ; Pakarinen, Mikko ; Mikkelsen, Audun ; Emblem, Ragnhild ; Svensson, Jan F. ; Ehrén, Henrik ; Jönsson, Linus ; Bäckstrand, Jakob ; Lilja, Helene Engstrand ; Donoso, Felipe ; Thorup, Jørgen Mogens ; Sæter, Thorstein ; Rasmussen, Lars ; Pedersen, Rikke Neess ; Stenström, Pernilla ; Arnbjörnsson, Einar ; Óskarsson, Kristján ; Qvist, Niels. / Surgical repair of long-gap esophageal atresia : A retrospective study comparing the management of long-gap esophageal atresia in the Nordic countries. In: Journal of Pediatric Surgery. 2019 ; Vol. 54, No. 3. pp. 423-428.
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title = "Surgical repair of long-gap esophageal atresia: A retrospective study comparing the management of long-gap esophageal atresia in the Nordic countries",
abstract = "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.",
keywords = "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",
author = "Tatjana Stadil and Antti Koivusalo and Mikko Pakarinen and Audun Mikkelsen and Ragnhild Emblem and Svensson, {Jan F.} and Henrik Ehr{\'e}n and Linus J{\"o}nsson and Jakob B{\"a}ckstrand and Lilja, {Helene Engstrand} and Felipe Donoso and Thorup, {J{\o}rgen Mogens} and Thorstein S{\ae}ter and Lars Rasmussen and Pedersen, {Rikke Neess} and Pernilla Stenstr{\"o}m and Einar Arnbj{\"o}rnsson and Kristj{\'a}n {\'O}skarsson and Niels Qvist",
year = "2019",
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doi = "10.1016/j.jpedsurg.2018.07.023",
language = "English",
volume = "54",
pages = "423--428",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
publisher = "W.B.Saunders Co.",
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Stadil, T, Koivusalo, A, Pakarinen, M, Mikkelsen, A, Emblem, R, Svensson, JF, Ehrén, H, Jönsson, L, Bäckstrand, J, Lilja, HE, Donoso, F, Thorup, JM, Sæter, T, Rasmussen, L, Pedersen, RN, Stenström, P, Arnbjörnsson, E, Óskarsson, K & Qvist, N 2019, 'Surgical repair of long-gap esophageal atresia: A retrospective study comparing the management of long-gap esophageal atresia in the Nordic countries', Journal of Pediatric Surgery, vol. 54, no. 3, pp. 423-428. https://doi.org/10.1016/j.jpedsurg.2018.07.023

Surgical repair of long-gap esophageal atresia : A retrospective study comparing the management of long-gap esophageal atresia in the Nordic countries. / Stadil, Tatjana; Koivusalo, Antti; Pakarinen, Mikko; Mikkelsen, Audun; Emblem, Ragnhild; Svensson, Jan F.; Ehrén, Henrik; Jönsson, Linus; Bäckstrand, Jakob; Lilja, Helene Engstrand; Donoso, Felipe; Thorup, Jørgen Mogens; Sæter, Thorstein; Rasmussen, Lars; Pedersen, Rikke Neess; Stenström, Pernilla; Arnbjörnsson, Einar; Óskarsson, Kristján; Qvist, Niels.

In: Journal of Pediatric Surgery, Vol. 54, No. 3, 03.2019, p. 423-428.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Surgical repair of long-gap esophageal atresia

T2 - A retrospective study comparing the management of long-gap esophageal atresia in the Nordic countries

AU - Stadil, Tatjana

AU - Koivusalo, Antti

AU - Pakarinen, Mikko

AU - Mikkelsen, Audun

AU - Emblem, Ragnhild

AU - Svensson, Jan F.

AU - Ehrén, Henrik

AU - Jönsson, Linus

AU - Bäckstrand, Jakob

AU - Lilja, Helene Engstrand

AU - Donoso, Felipe

AU - Thorup, Jørgen Mogens

AU - Sæter, Thorstein

AU - Rasmussen, Lars

AU - Pedersen, Rikke Neess

AU - Stenström, Pernilla

AU - Arnbjörnsson, Einar

AU - Óskarsson, Kristján

AU - Qvist, Niels

PY - 2019/3

Y1 - 2019/3

N2 - 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.

AB - 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.

KW - Esophageal atresia

KW - Gross type A

KW - Gross type B

KW - Long gap

KW - Postoperative complication

KW - Surgical repair

KW - Anastomosis, Surgical/adverse effects

KW - Humans

KW - Infant

KW - Treatment Outcome

KW - Scandinavian and Nordic Countries

KW - Esophagoplasty/adverse effects

KW - Postoperative Complications/epidemiology

KW - Esophagus/surgery

KW - Retrospective Studies

KW - Replantation/statistics & numerical data

KW - Esophageal Atresia/surgery

KW - Infant, Newborn

U2 - 10.1016/j.jpedsurg.2018.07.023

DO - 10.1016/j.jpedsurg.2018.07.023

M3 - Journal article

VL - 54

SP - 423

EP - 428

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

SN - 0022-3468

IS - 3

ER -