Simultaneous single-staged repair of anorectal malformation with tracheoesophageal fistula: Lessons learned

Introduction: Anorectal malformation (ARM) associated esophageal atresia (EA) with tracheoesophageal fistula (TEF) spawns special therapeutic propositions. The outcome of these patients banks on numerous factors. We performed this study with an aim to compare the outcome of single-staged simultaneou...

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Main Authors: Ajay Narayan Gangopadhyay, Vaibhav Pandey
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2017-01-01
Series:Journal of Indian Association of Pediatric Surgeons
Subjects:
Online Access:http://www.jiaps.com/article.asp?issn=0971-9261;year=2017;volume=22;issue=2;spage=96;epage=100;aulast=Gangopadhyay
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author Ajay Narayan Gangopadhyay
Vaibhav Pandey
author_facet Ajay Narayan Gangopadhyay
Vaibhav Pandey
author_sort Ajay Narayan Gangopadhyay
collection DOAJ
description Introduction: Anorectal malformation (ARM) associated esophageal atresia (EA) with tracheoesophageal fistula (TEF) spawns special therapeutic propositions. The outcome of these patients banks on numerous factors. We performed this study with an aim to compare the outcome of single-staged simultaneous primary repair of both anomalies versus staged repair of these disorders. Materials and Methods: Retrospective review of cases with ARM and associated EA with TEF managed over a period of 5 years from July 2010 to June 2015 after ethical approval was undertaken. Patients were split into two groups based on whether they underwent staged repair (Group A) or single-staged simultaneous primary repair of ARM with TEF (Group B). Patient's records were analyzed for demography, weight, gestational age, associated anomaly, preoperative and postoperative sepsis screen results, early and late postoperative complications (at least up to 1 year of age). Patient's Kelly score for continence at the age of 3 years or more was compared. Observation: A total of 28 were included in the study. Among these, 17 were managed with staged procedure for ARM (Group A), whereas 11 underwent simultaneous single-stage repair of ARM with TEF (Group B). No difference in continence score was observed in outcome between the two groups (P = 0.96). Overall mortality in Group A at 1-year follow-up was 52.9% and in Group B was 43.4%. Conclusion: The simultaneous single-staged primary repairs result in better long-term outcome in our setup.
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spelling doaj.art-ef9a9af2e698459ca69d392b9b9eb5412022-12-21T19:11:56ZengWolters Kluwer Medknow PublicationsJournal of Indian Association of Pediatric Surgeons0971-92611998-38912017-01-012229610010.4103/0971-9261.202682Simultaneous single-staged repair of anorectal malformation with tracheoesophageal fistula: Lessons learnedAjay Narayan GangopadhyayVaibhav PandeyIntroduction: Anorectal malformation (ARM) associated esophageal atresia (EA) with tracheoesophageal fistula (TEF) spawns special therapeutic propositions. The outcome of these patients banks on numerous factors. We performed this study with an aim to compare the outcome of single-staged simultaneous primary repair of both anomalies versus staged repair of these disorders. Materials and Methods: Retrospective review of cases with ARM and associated EA with TEF managed over a period of 5 years from July 2010 to June 2015 after ethical approval was undertaken. Patients were split into two groups based on whether they underwent staged repair (Group A) or single-staged simultaneous primary repair of ARM with TEF (Group B). Patient's records were analyzed for demography, weight, gestational age, associated anomaly, preoperative and postoperative sepsis screen results, early and late postoperative complications (at least up to 1 year of age). Patient's Kelly score for continence at the age of 3 years or more was compared. Observation: A total of 28 were included in the study. Among these, 17 were managed with staged procedure for ARM (Group A), whereas 11 underwent simultaneous single-stage repair of ARM with TEF (Group B). No difference in continence score was observed in outcome between the two groups (P = 0.96). Overall mortality in Group A at 1-year follow-up was 52.9% and in Group B was 43.4%. Conclusion: The simultaneous single-staged primary repairs result in better long-term outcome in our setup.http://www.jiaps.com/article.asp?issn=0971-9261;year=2017;volume=22;issue=2;spage=96;epage=100;aulast=GangopadhyayAnorectal malformationanorectal malformation with tracheoesophageal fistulaesophageal atresia
spellingShingle Ajay Narayan Gangopadhyay
Vaibhav Pandey
Simultaneous single-staged repair of anorectal malformation with tracheoesophageal fistula: Lessons learned
Journal of Indian Association of Pediatric Surgeons
Anorectal malformation
anorectal malformation with tracheoesophageal fistula
esophageal atresia
title Simultaneous single-staged repair of anorectal malformation with tracheoesophageal fistula: Lessons learned
title_full Simultaneous single-staged repair of anorectal malformation with tracheoesophageal fistula: Lessons learned
title_fullStr Simultaneous single-staged repair of anorectal malformation with tracheoesophageal fistula: Lessons learned
title_full_unstemmed Simultaneous single-staged repair of anorectal malformation with tracheoesophageal fistula: Lessons learned
title_short Simultaneous single-staged repair of anorectal malformation with tracheoesophageal fistula: Lessons learned
title_sort simultaneous single staged repair of anorectal malformation with tracheoesophageal fistula lessons learned
topic Anorectal malformation
anorectal malformation with tracheoesophageal fistula
esophageal atresia
url http://www.jiaps.com/article.asp?issn=0971-9261;year=2017;volume=22;issue=2;spage=96;epage=100;aulast=Gangopadhyay
work_keys_str_mv AT ajaynarayangangopadhyay simultaneoussinglestagedrepairofanorectalmalformationwithtracheoesophagealfistulalessonslearned
AT vaibhavpandey simultaneoussinglestagedrepairofanorectalmalformationwithtracheoesophagealfistulalessonslearned