Factors of esophageal atresia treatment outcome in newborns operated on at Department of Pediatric Surgery, Split University Hospital, during the 1991-2014 period

Abstract

Esophageal atresia is an anomaly that stands out from other anomalies in view of emergency, delicate postoperative treatment and the need for long-term treatment. The aim of this study was to determine epidemiological, demographic and clinical characteristics of patients operated on for esophageal atresia and compare them to other relevant studies. From January 1991 to September 2014, medical histories of 46 patients treated for esophageal atresia were retrospectively reviewed. Data were collected from protocols of the Department for Pediatric Surgery, Department of Neonatology and Intensive Care Unit (ICU), Split University Hospital archives and history of the disease. The following parameters were analyzed: date of birth, sex, birth weight, surgery, type of anomaly, survival, and early and late complications. Esophageal atresia was more frequent in females (60%). The most common type of esophageal atresia according to Vogt classifi cation was type 3B (92%). Overall mortality was 35%, noting that mortality before and after the introduction of ICU care was 80% and only 14%, respectively. Pneumonia was the most common early complication, whereas the most common late complications were dysphagia (35%) and anastomotic stricture (12%). Cardiovascular anomalies were the most common congenital malformations that accounted for 45% of all associated anomalies and found in 30% of the children with esophageal atresia. In conclusion, early recognition of this anomaly is of great importance, primarily due to the fact that it is a life-threatening anomaly the early diagnosis of which and surgery reduce complications and improve the outcome. A multidisciplinary approach and recognition of associated anomalies is necessary for child survival. In addition to early diagnosis, surgical postoperative intensive care is crucial for survival.