Determining the Risk Factors for Anastomotic Stricture Development after Esophageal Atresia Repair: Results from the Turkish Esophageal Atresia Registry.

IF 1.5 3区医学 Q2 PEDIATRICS

European Journal of Pediatric Surgery Pub Date : 2024-12-01 Epub Date: 2024-06-07 DOI:10.1055/a-2340-9078

Can İhsan Öztorun, Çiğdem Ulukaya Durakbaşa, Tutku Soyer, Coşkun Özcan, Binali Fırıncı, Berat Dilek Demirel, İlhan Çiftçi, Ayşe Parlak, Mustafa Onur Öztan, Gülnur Göllü Bahadır, İbrahim Akkoyun, Ayşe Karaman, Cengiz Gül, Gül Şalcı, Hüseyin İlhan, Akgün Oral, Rahşan Özcan, Seyithan Özaydın, Şeref Selçuk Kılıç, Gürsu Kıyan, Ali Onur Erdem, Osman Uzunlu, Abdullah Yıldız, Esra Özçakır, Nazile Ertürk, Başak Erginel, Tülin Öztaş, Ahmet Atıcı, Mehmet Mert, Hakan Samsum, Mehmet Ali Özen, Emrah Aydın, Serpil Sancar

{"title":"Determining the Risk Factors for Anastomotic Stricture Development after Esophageal Atresia Repair: Results from the Turkish Esophageal Atresia Registry.","authors":"Can İhsan Öztorun, Çiğdem Ulukaya Durakbaşa, Tutku Soyer, Coşkun Özcan, Binali Fırıncı, Berat Dilek Demirel, İlhan Çiftçi, Ayşe Parlak, Mustafa Onur Öztan, Gülnur Göllü Bahadır, İbrahim Akkoyun, Ayşe Karaman, Cengiz Gül, Gül Şalcı, Hüseyin İlhan, Akgün Oral, Rahşan Özcan, Seyithan Özaydın, Şeref Selçuk Kılıç, Gürsu Kıyan, Ali Onur Erdem, Osman Uzunlu, Abdullah Yıldız, Esra Özçakır, Nazile Ertürk, Başak Erginel, Tülin Öztaş, Ahmet Atıcı, Mehmet Mert, Hakan Samsum, Mehmet Ali Özen, Emrah Aydın, Serpil Sancar","doi":"10.1055/a-2340-9078","DOIUrl":null,"url":null,"abstract":"Introduction: Anastomotic stricture (AS) is the second most common complication after esophageal atresia (EA) repair. We aimed to evaluate the data in the Turkish Esophageal Atresia Registry to determine the risk factors for AS development after EA repair in a large national cohort of patients.Methods: The data between 2015 and 2021 were evaluated. Patients were enrolled into two groups according to the occurrence of AS. Patients with AS (AS group) and without AS (non-AS group) were compared according to demographic and operative features, postoperative intubation status, and postoperative complications, such as anastomotic leaks, fistula recanalization, and the presence of gastroesophageal reflux (GER). A multivariable logistic regression analysis was performed to define the risk factors for the development of AS after EA repair.Results: Among the 713 cases, 144 patients (20.19%) were enrolled into the AS group and 569 (79.81%) in the non-AS group. The multivariable logistic regression showed that, being a term baby (odds ratio [OR]: 1.706; p = 0.006), having a birth weight over 2,500 g (OR: 1.72; p = 0.006), presence of GER (OR: 5.267; p < 0.001), or having a recurrent tracheoesophageal fistula (TEF, OR: 4.363; p = 0.006) were the risk factors for the development of AS.Conclusions: The results of our national registry demonstrate that 20% of EA patients developed AS within their first year of life. In patients with early primary anastomosis, birth weight greater than 2,500 g and presence of GER were risk factors for developing AS. When patients with delayed anastomosis were included, in addition to the previous risk factors, being a term baby, and having recurrent TEF also became risk factors.Level of evidence: III.","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":"550-557"},"PeriodicalIF":1.5000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Pediatric Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2340-9078","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/7 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Anastomotic stricture (AS) is the second most common complication after esophageal atresia (EA) repair. We aimed to evaluate the data in the Turkish Esophageal Atresia Registry to determine the risk factors for AS development after EA repair in a large national cohort of patients.

Methods: The data between 2015 and 2021 were evaluated. Patients were enrolled into two groups according to the occurrence of AS. Patients with AS (AS group) and without AS (non-AS group) were compared according to demographic and operative features, postoperative intubation status, and postoperative complications, such as anastomotic leaks, fistula recanalization, and the presence of gastroesophageal reflux (GER). A multivariable logistic regression analysis was performed to define the risk factors for the development of AS after EA repair.

Results: Among the 713 cases, 144 patients (20.19%) were enrolled into the AS group and 569 (79.81%) in the non-AS group. The multivariable logistic regression showed that, being a term baby (odds ratio [OR]: 1.706; p = 0.006), having a birth weight over 2,500 g (OR: 1.72; p = 0.006), presence of GER (OR: 5.267; p < 0.001), or having a recurrent tracheoesophageal fistula (TEF, OR: 4.363; p = 0.006) were the risk factors for the development of AS.

Conclusions: The results of our national registry demonstrate that 20% of EA patients developed AS within their first year of life. In patients with early primary anastomosis, birth weight greater than 2,500 g and presence of GER were risk factors for developing AS. When patients with delayed anastomosis were included, in addition to the previous risk factors, being a term baby, and having recurrent TEF also became risk factors.

Level of evidence: III.

查看原文本刊更多论文

确定食道闭锁修复术后发生吻合口狭窄的风险因素：土耳其食道闭锁登记处的研究结果。

导言：吻合口狭窄（AS）是食管闭锁（EA）修复术后第二大常见并发症。我们旨在评估土耳其食道闭锁登记处的数据，以确定全国大型患者队列中食道闭锁修复术后出现吻合口狭窄的风险因素：方法：对2015年至2021年的数据进行评估。根据 AS 的发生情况，患者被分为两组。根据人口统计学和手术特征、术后插管情况以及术后并发症（如吻合口漏、瘘管再通和胃食管反流（GER）），对有AS患者（AS组）和无AS患者（无AS组）进行比较。为了确定EA修复术后发生强直性脊柱炎的风险因素，研究人员进行了多变量逻辑回归分析：在713例患者中，144例（20.19%）被纳入强直性脊柱炎组，569例（79.81%）被纳入非强直性脊柱炎组。多变量逻辑回归结果显示，足月儿（OR 1.706; p = 0.006）、出生体重超过 2500 克（OR 1.72; p = 0.006）、存在 GER（OR 5.267; p结论：我们的全国登记结果表明，20% 的 EA 患者在出生后第一年内发展为 AS。在早期初次吻合的患者中，出生体重大于 2500 克和存在胃食管反流是患 AS 的风险因素。如果将吻合术延迟的患者包括在内，除了之前的风险因素外，足月儿和复发性 TEF 也成为风险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Journal of Pediatric Surgery 医学-外科

CiteScore

3.90

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： This broad-based international journal updates you on vital developments in pediatric surgery through original articles, abstracts of the literature, and meeting announcements. You will find state-of-the-art information on: abdominal and thoracic surgery neurosurgery urology gynecology oncology orthopaedics traumatology anesthesiology child pathology embryology morphology Written by surgeons, physicians, anesthesiologists, radiologists, and others involved in the surgical care of neonates, infants, and children, the EJPS is an indispensable resource for all specialists.