Mustafa O Oztan1, Tutku Soyer2, Can I Oztorun3, Binali Firinci4, Çiğdem U Durakbaşa5, Zafer Dokumcu6, Gulnur Gollu7, Ibrahim Akkoyun8, Dilek Demirel9, Ayşe Karaman10, Ilhan Ciftci11, Huseyin Ilhan12, Ayse Parlak13, Onder Ozden14, Hatice S Y Cömert15, Akgun Oral16, Gonca Tekant17, Gursu Kiyan18, Başak Erginel19, Unal Guvenc20, Ali Onur Erdem21, Nazile Erturk22, Abdullah Yildiz23. 1. Department of Pediatric Surgery, Izmir Katip Celebi University, Izmir, Turkey. 2. Department of Pediatric Surgery, Hacettepe University, Ankara, Turkey. 3. Department of Pediatric Surgery, Ankara Yildirim Beyazit Universitesi, Ankara, Turkey. 4. Department of Pediatric Surgery, Ataturk University, Erzurum, Turkey. 5. Department of Pediatric Surgery, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey. 6. Department of Pediatric Surgery, Ege University, Izmir, Turkey. 7. Department of Pediatric Surgery, Ankara University, Ankara, Turkey. 8. Department of Pediatric Surgery, Konya Education and Research Hospital, Konya, Turkey. 9. Department of Pediatric Surgery, Ondokuz Mayıs University, Samsun, Turkey. 10. Department of Pediatric Surgery, Dr. Sami Ulus Maternity and Children Health and Research Application Center, University of Health Sciences, Ankara, Turkey. 11. Department of Pediatric Surgery, Selçuk University, Konya, Turkey. 12. Department of Pediatric Surgery, Eskisehir Osmangazi University, Eskisehir, Turkey. 13. Department of Pediatric Surgery, Uludag University, Bursa, Turkey. 14. Department of Pediatric Surgery, Cukurova University, Adana, Turkey. 15. Department of Pediatric Surgery, Karadeniz Technical University, Trabzon, Turkey. 16. Department of Pediatric Surgery, Dr. Behcet Uz Education and Research Hospital, Izmir, Turkey. 17. Department of Pediatric Surgery, Istanbul University-Cerrahpasa, Istanbul, Istanbul, Turkey. 18. Department of Pediatric Surgery, Marmara University, Istanbul, Turkey. 19. Department of Pediatric Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. 20. Department of Pediatric Surgery, Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey. 21. Department of Pediatric Surgery, Adnan Menderes University, Aydin, Turkey. 22. Department of Pediatric Surgery, Mugla Sitki Kocman University Ringgold standard institution, Mugla, Turkey. 23. Department of Pediatric Surgery, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey.
Abstract
INTRODUCTION: The data of the Turkish Esophageal Atresia Registry (TEAR) was evaluated to define the outcome of very low birth weight (VLBW) and low BW (LWB) infants with esophageal atresia (EA). MATERIALS AND METHODS: The data registered by 24 centers between 2014 and 2018 were evaluated for demographic features, prenatal findings, associated anomalies, surgical treatment, and outcome. Patients were enrolled in three groups according to their BWs (VLBW <1,500 g), LWB = 1,500-2,500 g), and normal BW (NBW; >2,500 g). RESULTS: Among the 389 cases, there were 37 patients (9.5%) in the VLBW group, 165 patients (42.4%) in the LBW group, and 187 patients (48.1%) in the NBW group. Prenatal diagnosis rates were similar among the three groups (29.7, 34.5, and 24.6%, respectively). The standard primary anastomosis was achieved at a significantly higher rate in NWB cases than in the other groups (p < 0.05). In patients with tracheoesophageal fistula (TEF), patients of the NBW group had significantly higher rates of full oral feedings, when compared with VLBW and LBW cases (p < 0.05). At the end of the first year, when we evaluate all patients, the number of cases with fistula recanalization and esophageal anastomotic strictures (AS) requiring esophageal dilatation was similar among the groups. The weight and height measurements at 6 months and 1 year of age of the survivors were similar in all the groups. The overall mortality rate was significantly higher in the VLBW and LBW groups, when compared with the NBW patients, even in patients with tension-free anastomosis (p < 0.05). The incidence of the associated anomalies was 90.6% in cases with mortality, which was significantly higher than in survivors (59.6%; p < 0.05). According to Spitz's classification, the survival rate was 87.1% in class I, 55.3% in class II, and 16.7% in class III. The most common causes of mortality were associated with cardiovascular diseases, pneumonia, and sepsis. CONCLUSION: The national data of TEAR demonstrates that the developmental and feeding parameters are better in NBW patients. Although VLBW patients have higher risk of developing fistula canalization than the LBW and NBW groups, long-term complications, such as anastomotic strictures, weight, and height values, after 1 year are similar in both groups. According to our results, associated anomalies and LBWs are still significant risk factors for mortality in cases with EA. Thieme. All rights reserved.
INTRODUCTION: The data of the Turkish Esophageal Atresia Registry (TEAR) was evaluated to define the outcome of very low birth weight (VLBW) and low BW (LWB) infants with esophageal atresia (EA). MATERIALS AND METHODS: The data registered by 24 centers between 2014 and 2018 were evaluated for demographic features, prenatal findings, associated anomalies, surgical treatment, and outcome. Patients were enrolled in three groups according to their BWs (VLBW <1,500 g), LWB = 1,500-2,500 g), and normal BW (NBW; >2,500 g). RESULTS: Among the 389 cases, there were 37 patients (9.5%) in the VLBW group, 165 patients (42.4%) in the LBW group, and 187 patients (48.1%) in the NBW group. Prenatal diagnosis rates were similar among the three groups (29.7, 34.5, and 24.6%, respectively). The standard primary anastomosis was achieved at a significantly higher rate in NWB cases than in the other groups (p < 0.05). In patients with tracheoesophageal fistula (TEF), patients of the NBW group had significantly higher rates of full oral feedings, when compared with VLBW and LBW cases (p < 0.05). At the end of the first year, when we evaluate all patients, the number of cases with fistula recanalization and esophageal anastomotic strictures (AS) requiring esophageal dilatation was similar among the groups. The weight and height measurements at 6 months and 1 year of age of the survivors were similar in all the groups. The overall mortality rate was significantly higher in the VLBW and LBW groups, when compared with the NBW patients, even in patients with tension-free anastomosis (p < 0.05). The incidence of the associated anomalies was 90.6% in cases with mortality, which was significantly higher than in survivors (59.6%; p < 0.05). According to Spitz's classification, the survival rate was 87.1% in class I, 55.3% in class II, and 16.7% in class III. The most common causes of mortality were associated with cardiovascular diseases, pneumonia, and sepsis. CONCLUSION: The national data of TEAR demonstrates that the developmental and feeding parameters are better in NBW patients. Although VLBW patients have higher risk of developing fistula canalization than the LBW and NBW groups, long-term complications, such as anastomotic strictures, weight, and height values, after 1 year are similar in both groups. According to our results, associated anomalies and LBWs are still significant risk factors for mortality in cases with EA. Thieme. All rights reserved.