Jamie Golden1, Natalie E Demeter2, Joanna C Lim3, Henri R Ford4, Jeffrey S Upperman5, Christopher P Gayer6. 1. Children's Hospital Los Angeles, Division of Pediatric Surgery, 4650 Sunset Blvd, Los Angeles, CA 90027, USA. Electronic address: Jgolden@chla.usc.edu. 2. Children's Hospital Los Angeles, Division of Pediatric Surgery, 4650 Sunset Blvd, Los Angeles, CA 90027, USA. Electronic address: nedemeter@gmail.com. 3. Children's Hospital Los Angeles, Division of Pediatric Surgery, 4650 Sunset Blvd, Los Angeles, CA 90027, USA. Electronic address: Joanna.c.lim@gmail.com. 4. Children's Hospital Los Angeles, Division of Pediatric Surgery, 4650 Sunset Blvd, Los Angeles, CA 90027, USA. Electronic address: Hford@chla.usc.edu. 5. Children's Hospital Los Angeles, Division of Pediatric Surgery, 4650 Sunset Blvd, Los Angeles, CA 90027, USA. Electronic address: Jupperman@chla.usc.edu. 6. Children's Hospital Los Angeles, Division of Pediatric Surgery, 4650 Sunset Blvd, Los Angeles, CA 90027, USA. Electronic address: Cgayer@chla.usc.edu.
Abstract
INTRODUCTION: Esophagrams are routinely performed following repair of esophageal atresia (EA) with or without tracheoesophageal fistula (TEF); however, its utility has not been validated. METHODS: EA/TEF repair performed from 2003 to 2014 at a single pediatric hospital and from 2004 to 2014 in the Pediatric Health Information System (PHIS) database were retrospectively reviewed to determine utility of esophagrams. RESULTS: Esophagram was performed in 99% of patients at our institution (N = 105). Clinical signs were seen prior to esophagram in patients whose leak changed clinical management. Esophagram on post-operative day ≤15 was performed in 66% of PHIS database patients (N = 3255). Esophagram did not change the incidence of chest tube placement, reoperation, or dilation. Patients who required a reoperation were less likely to have an esophagram than patients who did not require a reoperation (40.7% versus 65.7%, p < 0.001). CONCLUSION: Our data suggest that routine esophagram is not necessary in asymptomatic patients.
INTRODUCTION: Esophagrams are routinely performed following repair of esophageal atresia (EA) with or without tracheoesophageal fistula (TEF); however, its utility has not been validated. METHODS: EA/TEF repair performed from 2003 to 2014 at a single pediatric hospital and from 2004 to 2014 in the Pediatric Health Information System (PHIS) database were retrospectively reviewed to determine utility of esophagrams. RESULTS: Esophagram was performed in 99% of patients at our institution (N = 105). Clinical signs were seen prior to esophagram in patients whose leak changed clinical management. Esophagram on post-operative day ≤15 was performed in 66% of PHIS database patients (N = 3255). Esophagram did not change the incidence of chest tube placement, reoperation, or dilation. Patients who required a reoperation were less likely to have an esophagram than patients who did not require a reoperation (40.7% versus 65.7%, p < 0.001). CONCLUSION: Our data suggest that routine esophagram is not necessary in asymptomatic patients.
Authors: Kiera Roberts; Jonathan Karpelowsky; Dominic A Fitzgerald; Soundappan S V Soundappan Journal: Pediatr Surg Int Date: 2019-02-01 Impact factor: 1.827