Long-term outcomes of oesophageal atresia without or with proximal tracheooesophageal fistula - Gross types A and B

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dc.contributor.author Koivusalo, Antti I.
dc.contributor.author Sistonen, Saara J.
dc.contributor.author Lindahl, Harry G.
dc.contributor.author Rintala, Risto J.
dc.contributor.author Pakarinen, Mikko P.
dc.date.accessioned 2019-01-23T22:39:11Z
dc.date.available 2021-12-17T22:02:27Z
dc.date.issued 2017-10
dc.identifier.citation Koivusalo , A I , Sistonen , S J , Lindahl , H G , Rintala , R J & Pakarinen , M P 2017 , ' Long-term outcomes of oesophageal atresia without or with proximal tracheooesophageal fistula - Gross types A and B ' , Journal of Pediatric Surgery , vol. 52 , no. 10 , pp. 1571-1575 . https://doi.org/10.1016/j.jpedsurg.2017.04.021
dc.identifier.other PURE: 94628939
dc.identifier.other PURE UUID: 76744531-7e2f-46bd-8430-baf4c80eb305
dc.identifier.other WOS: 000415316900006
dc.identifier.other Scopus: 85019125101
dc.identifier.uri http://hdl.handle.net/10138/298135
dc.description.abstract Purpose: Because of an extended gap between esophageal pouches a variety of methods are employed to treat oesophageal atresia (OA) without (type A) or with (type B) proximal tracheooesophageal fistula. This retrospective observational study describes their single centre long-term outcomes from 1947 to 2014. Methods: Of 693 patients treated for OA 68 (9.7%) had type A (n = 58, 8.3%) or B (n = 10, 1.4%). Hospital records were reviewed. Main outcome measures were survival and oral intake. Results: Nine (13%) patients had early and 10 (15%) delayed primary anastomosis, 30 (44%) underwent reconstruction including colonic interposition (n = 13), reversed gastric tube (n = 11) and jejunum interposition (n = 6), whereas19 (28%) had died without a definite repair. Median follow up was 35 (interquartile range, 7.4-40) years. Thirty-one (63%) of 49 patients with definitive repair survived long term. Survival was 22% for early and 80% for delayed primary anastomosis, 57% for colon interposition, 82% for gastric tube and 84% for jejunum interposition. Gastrooesophageal reflux was most common after gastric tube (80%), dysphagia after colon interposition (50%), and 3 (60%) of 5 survivors with jejunum interposition had permanent feeding ostomy because of neurological disorder. Endoscopic follow-up disclosed no oesophageal cancer or dysplasia. Repair in the most recent patients from 1985 to 2014 (n = 14) included delayed primary anastomosis (n = 7), jejunum interposition (n = 6) and gastric tube (n = 1) with 93% long-term survival. Conclusion: Morbidity among long-term survivors of type A or B OA is high. With modern management survival is, however, excellent and patients without neurological disorder achieve full oral intake either after primary anastomosis or reconstruction. (C) 2017 Elsevier Inc. All rights reserved. en
dc.format.extent 5
dc.language.iso eng
dc.relation.ispartof Journal of Pediatric Surgery
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Oesophageal atresia
dc.subject Primary repair
dc.subject Gastric tube
dc.subject Colon interposition
dc.subject Jejunum interposition
dc.subject FOLLOW-UP
dc.subject SINGLE-CENTER
dc.subject CHILDREN
dc.subject REPLACEMENT
dc.subject EXPERIENCE
dc.subject TUBE
dc.subject REPAIR
dc.subject 3123 Gynaecology and paediatrics
dc.subject 3126 Surgery, anesthesiology, intensive care, radiology
dc.title Long-term outcomes of oesophageal atresia without or with proximal tracheooesophageal fistula - Gross types A and B en
dc.type Article
dc.contributor.organization Lastenkirurgian yksikkö
dc.contributor.organization Children's Hospital
dc.contributor.organization Clinicum
dc.contributor.organization University of Helsinki
dc.contributor.organization HUS Children and Adolescents
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1016/j.jpedsurg.2017.04.021
dc.relation.issn 0022-3468
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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