Arunjot Singh1, William Middlesworth2, Julie Khlevner3. 1. Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY, USA. 2. Division of Pediatric Surgery, Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY, USA. 3. Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY, USA. jk3065@cumc.columbia.edu.
Abstract
PURPOSE OF REVIEW: Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a congenital aerodigestive anomaly with high survival rates after surgical repair. Care should now be focused on prevention of long-term complications using appropriate surveillance techniques. RECENT FINDINGS: The incidence of gastroesophageal reflux disease (GERD) is high in patients with EA/TEF. Consequences of untreated GERD include esophagitis, strictures, and Barrett esophagus. Subjective symptoms are an unreliable indicator of presence or severity of GERD, and therefore, diagnostic testing is needed to assess esophageal heath and monitor the effectiveness of anti-reflux treatment. Esophagogastroduodenoscopy with biopsy remains the primary surveillance tool, but is invasive and not without risks. Less-invasive modalities such as multichannel intraluminal impedance and pH monitoring to assess GERD appear to correlate strongly with esophageal histology and may provide sufficient information to guide treatment. EA/TEF patients face numerous challenges that need to be considered. Routine surveillance protocols and close monitoring are warranted to assess complications. Further research is needed to delineate the frequency of esophagogastroduodenoscopy versus less-invasive and promising modalities such as multichannel intraluminal impedance-pH monitoring.
PURPOSE OF REVIEW: Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a congenital aerodigestive anomaly with high survival rates after surgical repair. Care should now be focused on prevention of long-term complications using appropriate surveillance techniques. RECENT FINDINGS: The incidence of gastroesophageal reflux disease (GERD) is high in patients with EA/TEF. Consequences of untreated GERD include esophagitis, strictures, and Barrett esophagus. Subjective symptoms are an unreliable indicator of presence or severity of GERD, and therefore, diagnostic testing is needed to assess esophageal heath and monitor the effectiveness of anti-reflux treatment. Esophagogastroduodenoscopy with biopsy remains the primary surveillance tool, but is invasive and not without risks. Less-invasive modalities such as multichannel intraluminal impedance and pH monitoring to assess GERD appear to correlate strongly with esophageal histology and may provide sufficient information to guide treatment. EA/TEFpatients face numerous challenges that need to be considered. Routine surveillance protocols and close monitoring are warranted to assess complications. Further research is needed to delineate the frequency of esophagogastroduodenoscopy versus less-invasive and promising modalities such as multichannel intraluminal impedance-pH monitoring.
Authors: Antti I Koivusalo; Mikko P Pakarinen; Harry G Lindahl; Risto J Rintala Journal: J Pediatr Gastroenterol Nutr Date: 2016-04 Impact factor: 2.839
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