Risk factors and management for anastomotic stricture after surgical reconstruction of esophageal atresia
Background/purpose: Anastomotic stricture (AS) is a major morbidity of patients with esophageal atresia (EA) after surgical reconstruction. Our study determined the risk factors of AS after EA reconstruction. The therapeutic efficacy and complications of esophageal dilatation for children with AS we...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-01-01
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| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664620302801 |
| _version_ | 1818655754658250752 |
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| author | Che-Ming Chiang Wen-Ming Hsu Mei-Hwei Chang Hong-Yuan Hsu Yen-Hsuan Ni Huey-Ling Chen Jia-Feng Wu |
| author_facet | Che-Ming Chiang Wen-Ming Hsu Mei-Hwei Chang Hong-Yuan Hsu Yen-Hsuan Ni Huey-Ling Chen Jia-Feng Wu |
| author_sort | Che-Ming Chiang |
| collection | DOAJ |
| description | Background/purpose: Anastomotic stricture (AS) is a major morbidity of patients with esophageal atresia (EA) after surgical reconstruction. Our study determined the risk factors of AS after EA reconstruction. The therapeutic efficacy and complications of esophageal dilatation for children with AS were also evaluated. Methods: Forty children treated for EA between January 2008 and December 2018 were included in this retrospective analysis. Esophageal dilatation was performed when AS was diagnosed. The therapeutic effect of esophageal dilatation was determined based on nutritional status, as assessed by the weight-for-age z-score. Results: Sixteen EA patients developed AS. A gap >1.5 cm between the esophageal pouches (P = 0.02) in patients with EA and type A EA was a risk factor for developing AS. A mean of 7.7 sessions of esophageal dilatation were performed per patient, and no complications occurred. The nutritional status of EA children with AS after dilatation was not inferior to that of the children without AS at the 6-month follow-up. Conclusion: A gap >1.5 cm between the esophageal pouches and type A EA are risk factors for AS after esophageal reconstruction. Esophageal dilatation is both safe and effective for managing strictures and improves nutritional status in EA children with AS. |
| first_indexed | 2024-12-17T03:14:43Z |
| format | Article |
| id | doaj.art-edd307c990454bdfa68794f41d4885e5 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-12-17T03:14:43Z |
| publishDate | 2021-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-edd307c990454bdfa68794f41d4885e52022-12-21T22:05:44ZengElsevierJournal of the Formosan Medical Association0929-66462021-01-011201404410Risk factors and management for anastomotic stricture after surgical reconstruction of esophageal atresiaChe-Ming Chiang0Wen-Ming Hsu1Mei-Hwei Chang2Hong-Yuan Hsu3Yen-Hsuan Ni4Huey-Ling Chen5Jia-Feng Wu6Department of Pediatrics, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan; Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanPediatric Surgery, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan; Corresponding author. Department of Surgery, National Taiwan University Hospital, No. 8, Chung-Shan S. Rd., Taipei, Taiwan.Department of Pediatrics, National Taiwan University Hospital, National Taiwan University, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Hospital, National Taiwan University, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Hospital, National Taiwan University, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Hospital, National Taiwan University, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan; Corresponding author. Department of Pediatrics, National Taiwan University Hospital, No. 8, Chung-Shan S. Rd., Taipei, Taiwan. Fax: +(886-2)-23114592.Background/purpose: Anastomotic stricture (AS) is a major morbidity of patients with esophageal atresia (EA) after surgical reconstruction. Our study determined the risk factors of AS after EA reconstruction. The therapeutic efficacy and complications of esophageal dilatation for children with AS were also evaluated. Methods: Forty children treated for EA between January 2008 and December 2018 were included in this retrospective analysis. Esophageal dilatation was performed when AS was diagnosed. The therapeutic effect of esophageal dilatation was determined based on nutritional status, as assessed by the weight-for-age z-score. Results: Sixteen EA patients developed AS. A gap >1.5 cm between the esophageal pouches (P = 0.02) in patients with EA and type A EA was a risk factor for developing AS. A mean of 7.7 sessions of esophageal dilatation were performed per patient, and no complications occurred. The nutritional status of EA children with AS after dilatation was not inferior to that of the children without AS at the 6-month follow-up. Conclusion: A gap >1.5 cm between the esophageal pouches and type A EA are risk factors for AS after esophageal reconstruction. Esophageal dilatation is both safe and effective for managing strictures and improves nutritional status in EA children with AS.http://www.sciencedirect.com/science/article/pii/S0929664620302801Esophageal atresiaAnastomotic strictureEsophageal dilatationNutritional status |
| spellingShingle | Che-Ming Chiang Wen-Ming Hsu Mei-Hwei Chang Hong-Yuan Hsu Yen-Hsuan Ni Huey-Ling Chen Jia-Feng Wu Risk factors and management for anastomotic stricture after surgical reconstruction of esophageal atresia Journal of the Formosan Medical Association Esophageal atresia Anastomotic stricture Esophageal dilatation Nutritional status |
| title | Risk factors and management for anastomotic stricture after surgical reconstruction of esophageal atresia |
| title_full | Risk factors and management for anastomotic stricture after surgical reconstruction of esophageal atresia |
| title_fullStr | Risk factors and management for anastomotic stricture after surgical reconstruction of esophageal atresia |
| title_full_unstemmed | Risk factors and management for anastomotic stricture after surgical reconstruction of esophageal atresia |
| title_short | Risk factors and management for anastomotic stricture after surgical reconstruction of esophageal atresia |
| title_sort | risk factors and management for anastomotic stricture after surgical reconstruction of esophageal atresia |
| topic | Esophageal atresia Anastomotic stricture Esophageal dilatation Nutritional status |
| url | http://www.sciencedirect.com/science/article/pii/S0929664620302801 |
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