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SURGICAL OUTCOME OF 65 CASES OF CONGENITAL ESOPHAGEAL ATRESIA WITH TRACHEOESOPHAGEAL FISTULA: EXPERIENCE OF 5 YEARS IN TWO INSTITUTES

Authors: Ahmed Z. Zain احمد زبار زين --- Salah S. Mahmood صلاح سلمان محمود --- Sarah Z. Fadhil سارة زهير فاضل
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2014 Volume: 12 Issue: 2 Pages: 168-172
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Congenital esophageal atresia and tracheoesophageal fistula are well-known congenital anomalies which affect 1 in 2400 – 4500 live births. The survival rate has dramatically improved in the last decades due to the advances in the neonatal intensive care, anesthetic management, ventilatory support and the surgical techniques.Objective:To evaluate the surgical outcomes and postoperative complications in patient with esophageal atresia and tracheoesophageal fistula who were admitted to our hospital.Methods:A retrospective study of 65 cases of esophageal atresia with distal tracheoesophageal fistula was studied over a period of 5 years from January 2008 to January 2013. Patients demographic, frequency of associated anomalies, postoperative complications and surgical outcomes were studied.Results:There were 38 male and 27 female with frequency of forty-seven (72%) infants were full term and 18 (28%) were preterm. Survival rate was (66%) for newborn who underwent surgery within the first 24 hours which was higher than those newborn with age above two days. Congenital heart disease was the commonest associated congenital anomalies and accounted for 28% of all our patients. Our patients developed many complications including respiratory tract infection (26%) and anastomatic leak (20%) as the most common complications.Conclusion:The survival rate of the patients with EA/TEF is influenced mainly by associated life -threatening congenital anomalies, prematurity of newborn and the age at the time of surgical repair.Keywords:Esophageal atresia, tracheoesophageal fistula, congenital anomalies.


Article
Early Outcome of Surgical Intervention of Esophageal Atresia and Tracheo‑esophageal Fistula in Erbil Pediatric Surgical Center

Author: Najat Abdulkadr Hamad, Hawkar Abdullah Kak‑Ahmed1, Nooraddin Ismail Allaquli
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2018 Volume: 15 Issue: 2 Pages: 129-134
Publisher: Babylon University جامعة بابل

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Abstract

Background: Esophageal atresia (EA) and treacheo-esophageal fistula occur in 1 out of every 3500 live births. Children born with EA have ahigher incidence of prematurity than the general population EA. The treatment of EA and tracheo-esophageal fistula, although still a challenge,represents one of the true successes of newborn surgery. Objective: The aim of this study cases with EA and/or tracheo-esophageal fistula inRapareen pediatric surgery center, Erbil, Iraq, regarding management, and early outcome. Materials and Methods: Fifty-three neonates wereenrolled in this study from October 2011 to September 2015. Preoperative investigations included chest X-ray, ultrasound of the abdomen,and echocardiography. All patients were resuscitated before surgical intervention. Statistical Package for the Social Sciences version 20 wasused for data analysis. Results: Out of 53 cases, 21 survived and 32 died. Thirty patients were male and 23 were female (male-to-female ratio1.3:1). Twelve were premature and 41 term babies. The most common type was EA and distal fistula in 47 cases, pure atresia in 5 cases, andEA with both distal and proximal fistula in one case. Presenting features were excessive salivation in all cases, failure to pass nasogastric tubein 98.1%, cyanosis in 69.8%, and chocking in 37.7%. Prenatal history of polyhydramnios was present in 67.9%. Eighteen cases had associatedanomalies, most of them were cardiac. Conclusion: EA with distal tracheo-esophageal fistula is the most common type of anomaly. Earlydiagnosis, weight, maturity, and associated anomalies are the most important factors that affect the outcome. Postoperative respiratory care isnecessary, especially for those who have a preoperative chest infection.

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