27. EPIDEMIOLOGICAL AND CLINICAL FEATURES, TREATMENT OUTCOMES, AND EARLY POST-OPERATIVE COMPLICATIONS OF CONGENITAL ESOPHAGEAL ATRESIA AT NGHE AN OBSTETRICS AND PEDIATRICS HOSPITAL
Main Article Content
Abstract
Objective: To describe the epidemiological and clinical features of congenital esophageal atresia (EA) and evaluate treatment outcomes, as well as early postoperative complications after EA repair at Nghe An Obstetrics and Pediatrics Hospital.
Materials and methods: A descriptive cross-sectional study of 32 patients diagnosed and surgically treated for congenital esophageal atresia at Nghe An Obstetrics and Pediatrics Hospital from January 2021 to June 2024.
Results: The male-to-female ratio was 1.5/1. The most common symptom leading to hospitalization was respiratory failure, which accounted for 84.38%. According to Waterson classification, EA type C was predominant with 29 cases accounted for 90.62%, and the percentage of EA type A was 46.88%. Based on the Spitz classification, most patients were classified in group I, accounting for 56.25%. Early post-operative complications included esophageal fistula in 28.12%, postoperative pneumonia in 59.37%, sepsis in 34.37%, anastomotic stricture in 9.37%, and surgical wound bleeding in 6.25%. The survival rate after EA surgery was 71.88%.
Conclusions: Accurately identifications of the gap between the two ends of the esophagus is crucial for deciding the surgical method, timing of surgery, and postoperative care in order to reduce the incidence of anastomotic fistula. Sufficient critical care is essential in minimizing the rates of pneumonia and sepsis during post-operative period, which ultimately reduce mortality.
Article Details
Keywords
Clinical epidemiology, early complications, congenital esophageal atresia surgery
References
[2] Y. El-Gohary, G. K. Gittes, and J. A. Tovar, “Congenital anomalies of the esophagus,” Semin. Pediatr. Surg., vol. 19, no. 3, pp. 186–193, Aug. 2010, doi: 10.1053/j.sempedsurg.2010.03.009.
[3] L. Spitz, “Oesophageal atresia,” Orphanet J. Rare Dis., vol. 2, p. 24, May 2007, doi: 10.1186/1750-1172-2-24.
[4] T. Kovesi, “Long-term respiratory complications of congenital esophageal atresia with or without tracheoesophageal fistula: an update,” Dis. Esophagus Off. J. Int. Soc. Dis. Esophagus, vol. 26, no. 4, pp. 413–416, 2013, doi: 10.1111/dote.12061.
[5] R. K. Tandon et al., “Esophageal atresia: Factors influencing survival - Experience at an Indian tertiary centre,” J. Indian Assoc. Pediatr. Surg., vol. 13, no. 1, pp. 2–6, 2008, doi: 10.4103/0971-9261.42564.
[6] P. Bagolan, L. Valfrè, F. Morini, and A. Conforti, “Long-gap esophageal atresia: traction-growth and anastomosis - before and beyond,” Dis. Esophagus Off. J. Int. Soc. Dis. Esophagus, vol. 26, no. 4, pp. 372–379, 2013, doi: 10.1111/dote.12050.
[7] Nguyễn Thanh Liêm, Trần Minh Điển (2013.) Kết quả điều trị teo thực quản bẩm sinh bằng phẫu thuật nội soi ở trẻ em, sản phẩm khoa học công nghệ để tài cấp nhà nước, Bộ Khoa học và Công nghệ.
[8] J. E. Foker, B. C. Linden, E. M. Boyle, and C. Marquardt, “Development of a true primary repair for the full spectrum of esophageal atresia.,” Ann. Surg., vol. 226, no. 4, pp. 533–543, Oct. 1997.
[9] V. D. Upadhyaya et al., “Prognosis of congenital tracheoesophageal fistula with esophageal atresia on the basis of gap length,” Pediatr. Surg. Int., vol. 23, no. 8, pp. 767–771, Aug. 2007, doi: 10.1007/s00383-007-1964-0.
[10] A. K. Brown and P. K. Tam, “Measurement of gap length in esophageal atresia: a simple predictor of outcome,” J. Am. Coll. Surg., vol. 182, no. 1, pp. 41–45, Jan. 1996.