Tatjana Stadil1, Antti Koivusalo2, Mikko Pakarinen3, Audun Mikkelsen4, Ragnhild Emblem5, Jan F Svensson6, Henrik Ehrén7, Linus Jönsson8, Jakob Bäckstrand9, Helene Engstrand Lilja10, Felipe Donoso11, Jørgen Mogens Thorup12, Thorstein Sæter13, Lars Rasmussen14, Rikke Neess Pedersen15, Pernilla Stenström16, Einar Arnbjörnsson17, Kristján Óskarsson18, Niels Qvist19. 1. Surgical Department A, Odense University Hospital, Odense, Denmark. Electronic address: Tatjana.stadil@rsyd.dk. 2. Dept. of Pediatric Surgery, Children's Hospital, University of Helsinki, Helsinki, Finland. Electronic address: Antti.Koivusalo@hus.fi. 3. Dept. of Pediatric Surgery, Children's Hospital, University of Helsinki, Helsinki, Finland. Electronic address: Mikko.Pakarinen@hus.fi. 4. Dept. of Gastric and Pediatric Surgery, Oslo University Hospital, Rikshospitalet and Ullevål, Oslo, Norway. Electronic address: Audun.mikkelsen@medisin.uio.no. 5. Dept. of Gastric and Pediatric Surgery, Oslo University Hospital, Rikshospitalet and Ullevål, Oslo, Norway. Electronic address: Remblem@ous-hf.no. 6. Department of Pediatric Surgery, Karolinska University Hospital and Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden. Electronic address: Jan.f.svensson@sll.se. 7. Department of Pediatric Surgery, Karolinska University Hospital and Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden. Electronic address: Henrik.ehren@karolinska.sll.se. 8. Department of Pediatric Surgery, Queen Silvia Children's Hospital, Gothenburg, Sweden. Electronic address: Linus.jonsson@vgregion.se. 9. Department of Pediatric Surgery, Queen Silvia Children's Hospital, Gothenburg, Sweden. Electronic address: Jakob.backstrand@vgregion.se. 10. Department of Pediatric Surgery, Children's Hospital and Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. Electronic address: Helene.lilja@kbh.uu.se. 11. Department of Pediatric Surgery, Children's Hospital and Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. Electronic address: Felipe.donoso@kbh.uu.se. 12. Dept. of Pediatric Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. Electronic address: Joergen.mogens.thorup@regionh.dk. 13. Dept. of Pediatric Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Electronic address: Thorstein.Seter@stolav.no. 14. Surgical Department A, Odense University Hospital, Odense, Denmark. Electronic address: Lars.Rasmussen@rsyd.dk. 15. Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark. Electronic address: Rikke.Neess.Pedersen@rsyd.dk. 16. Dept. of Pediatrics, Children's Hospital, Lund University, Lund, Sweden. Electronic address: Pernilla.stenstrom@med.lu.se. 17. Dept. of Pediatrics, Children's Hospital, Lund University, Lund, Sweden. Electronic address: Einar.arnbjornsson@telia.com. 18. Children's Hospital, University Hospital, Reykjavik, Iceland. Electronic address: Kristosk@landspitali.is. 19. Surgical Department A, Odense University Hospital, Odense, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark. Electronic address: Niels.qvist@rsyd.dk.
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.
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.
Authors: Emma Svensson; Peter Zvara; Niels Qvist; Lars Hagander; Sören Möller; Lars Rasmussen; Henrik Daa Schrøder; Eva Kildall Hejbøl; Niels Bjørn; Súsanna Petersen; Kristine Cederstrøm Larsen; Jan Krhut; Oliver J Muensterer; Mark Bremholm Ellebæk Journal: Int J Surg Protoc Date: 2021-08-11