Esophageal atresia: our experiences in a university hospital

Abstract

Introduction and aim Esophageal atresia is a relatively common congenital malformation occurring one in 2500–3000 live births. The aim of this study was to determine the frequency, type of anomaly, and mortality and to detect the associated anomaly in patients with esophageal atresia.
Patients and methods All neonates with diagnosis of esophageal atresia who were referred to pediatric surgery ward of Imam Khomeini Hospital were included in this study. Duration of this study was 10 years from 20 March 1997 to 20 March 2006. For comparison, duration of the study was divided into two periods (1997–2001 and 2002–2006). Sex, mortality rate, associated anomalies, type of atresia, mortality, performing thoracostomy or gastrostomy, and packed cell infusion were studied. Gross classification was used for typing of anomaly. Analysis was performed using the Pearson v2-test and analysis of variance using SPSS.
Results In this study, 198 (male = 100, female = 98) neonates were included. The most frequent type of atresia was type C (93.4%). Overall mortality rate was 50%. Mortality during the first period was 54.43% and during the second period was 47.05% (P = 0.384). The mean age at the second surgery was significantly higher in type D patients compared with others. The rate of gastrostomy was significantly higher during the first period (89.87%) compared with the second period of study (79.27%) (P = 0.002). The rate of cervical esophagostomy was decreased from 8.86 to 4.23% (P = 0.228).
Conclusion Mortality rate has decreased in our hospitals. The rate of gastrostomy decreased during the second period of study. The age at the first surgery was significantly higher in type D classification patients.

Keywords: esophageal atresia, gastrostomy, morbidity, mortality, thoracostomy, tracheoesophageal fistula, VACTERL syndrome