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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2014 April;27(2):89-92
Esophageal atresia experience of a tertiary center: does delayed diagnosis effect the prognosis? What are the factors affecting mortality?
Erdoğan D., Karaman I., Çavuşoğlu Y. H., Tuncer I. S., Karaman A., Özgüner I. F.
Pediatric Surgery Department, Dr Sami Ulus Maternity and Children’s Research and Training Hospital Ankara, Turkey
AIM: Esophagus atresia and or tracheoesophageal fistula, is a relatively common pathology of the newborn period frequently accompanied by other abnormalities. First aim of this study was to evaluate the cases operated on for esophagus atresia at our hospital and to determine the morbidity and mortality in patients with delayed diagnosis and secondly to determine the factors effective on mortality
METHODS: Esophagus atresia patients treated between the years 2005 and 2010 were retrospectively analyzed. The patients were grouped as those diagnosed before (group 1) and after (group 2) 48 hours and compared for morbidity and mortality. Furthermore they were classified according to their survival. The effects of factors on mortality were studied.
RESULTS: A total of 52 babies were treated with a diagnosis of esophagus atresia and/or tracheoesophageal fistula in six years. The mean birth weight was 2511 g (1210-3750 g). The accompanying disorders were major cardiac abnormality in 25%, urogenital abnormality in 15.4%, and VACTERL association in 15.4%. The time of diagnosis of the patients was found to be before 48 hours in 66% (group 1) and after 48 hours (delayed) in 34% (group 2). There was no difference between group 1 and group 2 regarding morbidity and mortality. Lower gestational age and VACTERL association were defined as the factors increasing mortality.
CONCLUSION: We determined that the additional abnormalities were the most important factor determining prognosis in the treatment of esophageal atresia and delayed diagnosis of newborns had no effect on morbidity and mortality when the proper preoperative and postnatal approach was used.