Objective The aim of this study is to characterize long-term morbidities of oesophageal atresia(OA)with or without tracheoesophageal fistula(TOF).Methods Infants born with OA/TOF from 2000 to 2016 in Western Australia...Objective The aim of this study is to characterize long-term morbidities of oesophageal atresia(OA)with or without tracheoesophageal fistula(TOF).Methods Infants born with OA/TOF from 2000 to 2016 in Western Australia were included for analysis.Infants were categorized into high-risk and low-risk groups based on the presence of one or more perioperative risk factors[low birth weight,vertebraldefects,anal atresia,cardiac defects,TOF,renalanomalies,limb abnormalities(VACTERL),anastomotic leak,long gap OA,and failure to establish oral feeds within the first month]identified by a previous Canadian study.Frequency of morbidities in infants with perioperative risk factors was compared.Results Of 102 patients,88(86%)had OA with distal TOF(type C).The most common morbidities in our cohort were anastomotic oesophageal strictures(AS)(n=53,52%),tracheomalacia(n=48,47%),gastroesophageal reflux disease(GORD)(n=42,41%)and recurrent respiratory tract infections(n=40,39%).Presence of GORD(30/59 vs 12/43,p=0.04)and median frequency of AS dilatations(8 vs 3,n=59,p=0.03)were greater in the high-risk group.This study further confirmed that inability to be fed orally within the first month was associated with high morbidities.Conclusions Gastrointestinal and respiratory morbidities remain high in OA/TOF regardless of perioperative risk factors.Inability to be fed orally within the first month is a predictor of poor outcomes with high frequency of gastrointestinal and respiratory comorbidities.展开更多
文摘Objective The aim of this study is to characterize long-term morbidities of oesophageal atresia(OA)with or without tracheoesophageal fistula(TOF).Methods Infants born with OA/TOF from 2000 to 2016 in Western Australia were included for analysis.Infants were categorized into high-risk and low-risk groups based on the presence of one or more perioperative risk factors[low birth weight,vertebraldefects,anal atresia,cardiac defects,TOF,renalanomalies,limb abnormalities(VACTERL),anastomotic leak,long gap OA,and failure to establish oral feeds within the first month]identified by a previous Canadian study.Frequency of morbidities in infants with perioperative risk factors was compared.Results Of 102 patients,88(86%)had OA with distal TOF(type C).The most common morbidities in our cohort were anastomotic oesophageal strictures(AS)(n=53,52%),tracheomalacia(n=48,47%),gastroesophageal reflux disease(GORD)(n=42,41%)and recurrent respiratory tract infections(n=40,39%).Presence of GORD(30/59 vs 12/43,p=0.04)and median frequency of AS dilatations(8 vs 3,n=59,p=0.03)were greater in the high-risk group.This study further confirmed that inability to be fed orally within the first month was associated with high morbidities.Conclusions Gastrointestinal and respiratory morbidities remain high in OA/TOF regardless of perioperative risk factors.Inability to be fed orally within the first month is a predictor of poor outcomes with high frequency of gastrointestinal and respiratory comorbidities.
