Long-term analysis of children with esophageal atresia and tracheoesophageal fistula
Section snippets
Materials and methods
From May 1972 to December 1990 (18.7 years), 69 children with EA/TEF have been treated at our institution and were available for long-term follow-up. Study approval from the institutional review board (IRB) was obtained. The medical records of these infants were reviewed to discover residual symptoms or complications that arose during infancy, elementary years, or teenage years. Children were seen annually in clinic. Symptoms and parental concerns were evaluated at 5-year intervals. The study
Results
Thirty-seven boys and 32 girls were included in the study. Initial repair was carried out through a right extrapleural thoracotomy with division of TEF and primary single layer esophagoesophagostomy, often with prior gastrostomy placement. Esophageal replacement with colonic interposition was utilized in 7 of 10 type A patients. Forty-nine infants (71%) received gastrostomy tubes at the discretion of the attending surgeon. Gastrostomy was maintained until the child showed adequate nutritional
Discussion
Children with EA/TEF have a significant incidence of gastroesophageal reflux. Postoperatively, esophageal motility disorders are observed. Esophageal peristalsis is impaired, whereas the lower esophageal sphincter may be incompetent.5, 6, 7 Several studies have reported an increased incidence of gastroesophageal reflux after EA/TEF repair; however, the definitions have not been uniform. Furthermore, discrepancy between subjective reflux and documented gastroesophageal reflux disease is likely
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