Hiroomi Okuyama1, Yuko Tazuke2, Takehisa Uenoa2, Hiroaki Yamanaka2, Yuichi Takama2, Ryuta Saka2, Keigo Nara3, Noriaki Usui3. 1. Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan. okuyama@pedsurg.med.osaka-u.ac.jp. 2. Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan. 3. Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodocho, Izumi, Osaka, 594-1101, Japan.
Abstract
PURPOSE: To investigate the long-term morbidity of surgically treated esophageal atresia (EA) in adolescents and young adults and establish whether these long-term morbidities are affected by the type of EA. PATIENTS AND METHODS: We reviewed the medical records, including backgrounds and associated conditions, of 69 long-term survivors of EA, aged >15 years. The long-term morbidities included neurodevelopmental abnormality, nutritional impairment (short height <-2SD, low BMI <18.5), subjective symptoms, and musculoskeletal deformities. Comparisons of the results were made between Gross A-type EA (n = 6) and Gross C-type EA (n = 63). RESULTS: All patients underwent esophageal anastomosis without esophageal replacement. Cardiac anomalies and long gap were present in 26 and 18%, respectively. Esophageal dilatation, fundoplication, and aortopexy were performed in 40, 34, and 18%, respectively. The incidence of long gap and esophageal stenosis was higher in Gross A-type EA than in Gross C-type EA. The long-term morbidities included neurodevelopmental abnormality (13%), nutritional impairment (62%: as short height in 34% and as low BMI in 46%), subjective symptoms (14%), and musculoskeletal deformities (59%). There were no differences in the long-term morbidities between Gross A and Gross C. CONCLUSIONS: The incidence of the long-term morbidities is high in adolescents and young adults, regardless of the type of EA. Early detection of morbidity is important to improve the long-term outcomes of EA.
PURPOSE: To investigate the long-term morbidity of surgically treated esophageal atresia (EA) in adolescents and young adults and establish whether these long-term morbidities are affected by the type of EA. PATIENTS AND METHODS: We reviewed the medical records, including backgrounds and associated conditions, of 69 long-term survivors of EA, aged >15 years. The long-term morbidities included neurodevelopmental abnormality, nutritional impairment (short height <-2SD, low BMI <18.5), subjective symptoms, and musculoskeletal deformities. Comparisons of the results were made between Gross A-type EA (n = 6) and Gross C-type EA (n = 63). RESULTS: All patients underwent esophageal anastomosis without esophageal replacement. Cardiac anomalies and long gap were present in 26 and 18%, respectively. Esophageal dilatation, fundoplication, and aortopexy were performed in 40, 34, and 18%, respectively. The incidence of long gap and esophageal stenosis was higher in Gross A-type EA than in Gross C-type EA. The long-term morbidities included neurodevelopmental abnormality (13%), nutritional impairment (62%: as short height in 34% and as low BMI in 46%), subjective symptoms (14%), and musculoskeletal deformities (59%). There were no differences in the long-term morbidities between Gross A and Gross C. CONCLUSIONS: The incidence of the long-term morbidities is high in adolescents and young adults, regardless of the type of EA. Early detection of morbidity is important to improve the long-term outcomes of EA.
Authors: A Pini Prato; M Carlucci; P Bagolan; P G Gamba; M Bernardi; E Leva; G Paradies; C Manzoni; B Noccioli; A Tramontano; V Jasonni; F Vaccarella; S De Pascale; D Alberti; G Riccipetitoni; D Falchetti; F Caccia; G Pelizzo; J Schleef; M Lima; P Andriolo; A Franchella; A Cacciari; F Caravaggi; S Federici; M Andermarcher; G Perrino; D Codrich; F S Camoglio; F S Chiarenza; A Martino; A Appignani; V Briganti; S Caterino; D Cozzi; M Messina; A Rizzo; L Liotta; D Salerno; M G R Aceti; F Bartoli; C Romeo; C Esposito; P L Lelli Chiesa; E Clemente; L Mascia; S Cacciaguerra; V Di Benedetto; S Licciardi; E De Grazia; M Ubertazzi; G Piazza; G Mattioli; F Rossi; M Nobili Journal: J Pediatr Surg Date: 2015-01-16 Impact factor: 2.545
Authors: Jason P Sulkowski; Jennifer N Cooper; Joseph J Lopez; Yamini Jadcherla; Alissabeth Cuenot; Peter Mattei; Katherine J Deans; Peter C Minneci Journal: Surgery Date: 2014-03-14 Impact factor: 3.982
Authors: Andrew C F Taylor; Kerry J Breen; Alex Auldist; Anthony Catto-Smith; Tom Clarnette; Joe Crameri; Russell Taylor; Satish Nagarajah; Jocelyn Brady; Keith Stokes Journal: Clin Gastroenterol Hepatol Date: 2007-06 Impact factor: 11.382