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The intensive care and surgery of esophageal atresia: outcomes of treatment in the regional children’s hospital

[Surgery]
Rustam Faridovich Mukhametshin; Nikita V. Toropov; OlgaTenyakova Gabdrakhmanova;

Esophageal atresia (EA) is the most common congenital abnormality of the oesophagus. The survival rate of patients with this defect varies from 86.9 % to 95 %. Seventy eight newborns with EA were treated from 2011 to 2017; 58.9 % were male children, 48.7 % were premature, 51.3 % had associated anomalies. Mortality was 10.25 % and was associated with severe prematurity and sepsis. Direct esophagoesophagoanastomosis was formed in 60 (76.9 %) children, cervical esophagostomy with gastrostomy – in 17 (21.8 %) children. Postoperative morbidity occurred in 76,9 % of the population, including 4 (6.7 %) cases with anastomotic leak and anastomotic stricture in 43 (71.7 %), in those patients, who had anastomosis; recurrent fistula in 2 (2.6 %), pneumonia in 22 (28.2 %) and late-onset sepsis in 13 (16.7 %). Our study also highlights issues related to respiratory support, nutritional support and antibiotic therapy. integrated approach has improved the quality andlevel of specialized care for children with EA.

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References:
1. Pedersen R. N., Calzolari E., Husby S., Garne E. Oesophageal atresia: prevalence, prenatal diagnosis and associated anomalies in 23 European regions. Arch. Dis. Child. 2012;97(3):227-232. https://doi.org/10.1136/archdischild-2011-300597
2. Sfeir R., Bonnard A., Khen-Dunlop N., Auber F., Gelas T. [et al.]. Esophageal atresia: Data from a national cohort. J. Pediatr. Surg. 2013;48(8):1664-1669. https://doi.org/10.1016/j.jpedsurg.2013.03.075
3. Zani A., Eaton S., Hoellwarth M.E., Puri P., Tovar J. [et al.]. International survey on the management of esophageal atresia. Europ. J. Ped. Surg. 2014;24(1):3-8. https://doi.org/10.1055/s-0033-1350058
4. Kozlov U. A., Novozhilov V. A., Razumovsky A. U. Surgical diseases of premature babies. National guide. Moscow: «GEOTAR-Media», 2019 (In Russ.).
5. Vukadin M., Savic D., Malikovic A., Jovanovic D., Milickovic M. [et al.]. Analysis of Prognostic Factors and Mortality in Children with Esophageal Atresia. Indian J. Pediatr. 2015;82(7):586-590. https://doi.org/10.1007/s12098-015-1730-6
6. Lal D. R., Gadepalli S. K., Downard C. D., Ostlie D. J., Minneci P. C. [et al.]. Perioperative management and outcomes of esophageal atresia and tracheoesophageal fistula. J. Pediatr. Surg. 2017;52(8):1245-1251. https://doi.org/10.1016/j.jpedsurg.2016.11.046
7. Burge D. M., Shah K., Spark P., Shenker N., Pierce M. [et al.]. Contemporary management and outcomes for infants born with oesophageal atresia. Brit. J. Surg. 2013;100(4):515-521. https://doi.org/10.1002/bjs.9019
8. Hartley M. J., Smith N. P.M., Jaffray B. Statistical modelling of survival for babies with oesophageal atresia. J. Pediatr. Surg. 2016;51(7):1110-1114. https://doi.org/10.1016/j.jpedsurg.2015.11.016
9. Yamoto M., Nomura A., Fukumoto K., Takahashi T., Nakaya K. [et al.]. New prognostic classification and managements in infants with esophageal atresia. Pediatr. Surg. Int. 2018;34(10):1019-1026. https://doi.org/10.1007/s00383-018-4322-5
10. Hannon E. J., Billington J., Kiely E. M., Pierro A., Spitz L. [et al.]. Oesophageal atresia is correctable and survivable in infants less than 1 kg. Pediatr. Surg. Int. 2016;32(6):571-576. https://doi.org/10.1007/s00383-015-3851-4
11. Sulkowski J. P., Cooper J. N., Lopez J. J., Jadcherla Y., Cuenot A. [et al.]. Morbidity and mortality in patients with esophageal atresia. Surgery. 2014;156(2):483-491. https://doi.org/10.1016/j.surg.2014.03.016
12. Thompson A., Thakkar H., Khan H., Yardley I. E. Not all Neonates with Oesophageal Atresia and Tracheoeso phageal Fistula Are a Surgical Emergency. J. Pediatr. Surg. 2019;54(2):244-246. https://doi.org/10.1016/j.jpedsurg.2018.10.074
13. Wang B., Tashiro J., Allan B. J., Sola J. E., Parikh P. P. [et al.]. A nationwide analysis of clinical outcomes among newborns with esophageal atresia and tracheoesophageal fistulas in the United States. J. Surg. Res. 2014;190(2):604-612. https://doi.org/10.1016/j.jss.2014.04.033
14. Al-Salem A. H., Kothari M., Oquaish M., Khogeer S., Desouky M. S. Morbidity and Mortality in Esophageal Atresia and Tracheoesophageal Fistula: A 20-Year Review. Ann. Ped. Surg. 2013;9(3):93-98. https://doi.org/10.1097/01.XPS.0000430524.83127.5d
15. Okata Y., Maeda K, Bitoh Y., Mishima Y., Tamaki A. [et al.]. Evaluation of the intraoperative risk factors for esophageal anastomotic complications after primary repair of esophageal atresia with tracheoesophageal fistula. Pediatr. Surg. Int. 2016;32(9):869-873. https://doi.org/10.1007/s00383-016-3931-0
16. O’Connell J. S., Janssen Lok M., Miyake H., Seo S., Bindi E. [et al.]. Post-operative paralysis and elective ventilation reduces anastomotic complications in esophageal atresia: a systematic review and metaanalysis. Pediatr. Surg. Int. 2019;35(1):87-95. https://doi.org/10.1007/s00383-018-4379-1
17. Zani A., Wolinska J., Cobellis G., Chiu P.P., Pierro A. Outcome of esophageal atresia/tracheoesophageal fistula inи extremely low birth weight neonates (

Keywords: еsophageal atresia, neonatal surgery, neonatal intensive care


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Pyatigorsk State Research Institute of Balneotherapeutics
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