Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
    Users Online: 414
Home Print this page Email this page Small font size Default font size Increase font size
ORIGINAL ARTICLE
Year : 2018  |  Volume : 7  |  Issue : 1  |  Page : 14-22

Esophageal atresia: Early outcome analysis from a high-volume tertiary care institute in India


Department of Paediatric Surgery, SMS Medical College, Jaipur, Rajasthan, India

Correspondence Address:
Rahul Gupta
Department of Paediatric Surgery, SMS Medical College, Jaipur, Rajasthan
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjhs.sjhs_116_17

Rights and Permissions

Context: Despite the progress made in the field of surgical techniques and neonatal care, conditions such as prematurity, very low birth weight, and associated anomalies compounded with delayed diagnosis may negatively influence the successful outcome of esophageal atresia (EA). Aims: The aim is to study the early outcome analysis of patients with EA and tracheoesophageal fistula (TEF) at a high-volume tertiary care institute. Settings and Design: A retrospective study performed from January 2016 to December 2016. Subjects and Methods: The study included all patients of EA and TEF admitted in the Neonatal Intensive Care Unit of our department. Results: There were 430 new cases of EA/TEF. Type C was the most common (90.23%), followed by Type A (8.37%), Type E (0.69%), and one case each of Type D, esophageal web, and esophageal stenosis. Two hundred and twenty-four (52.10%) remained undiagnosed on the 1st day of life. The average birth weight was 2200 g; 64.65% of patients were low birth weight. Associated major anomalies were present in 18.84% patients with gastrointestinal tract anomalies in 13.49% cases (anorectal malformation – 11.86%, duodenal atresia [DA] – 2.79%, and triple atresia – 0.93%) and VACTERL association in 11.63%. Surgical procedures were performed in 413 (96.05%) patients. Survival was seen in 29.77% cases, mortality in 68.84% and 1.39% patients left against the medical advice. The survival was better in Type C (29.89%) than Type A (27.78%) and also those without associated anomalies. VACTERL association had a very high (80%)-mortality rate. Septicemia (63.85%), severe pneumonia (53.71%), and congestive heart failure (24.32%) were main causes of mortality. Conclusions: Although there has been a marked improvement in the antenatal diagnosis of EA, most cases in our study remain undiagnosed in first 24 h of birth. Associated major anomalies were documented in approximately 1/5th patients. Survival was present in less than 1/3rd patients; survival outcomes were better in EA without associated anomalies. Early diagnosis with the help of red rubber catheter shortly after birth, measures to prevent pneumonia, strict infection control measures for prevention of septicemia, deployment of sufficient resources, and investigations for other associated anomalies are recommended to improve the outcomes of EA.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed430    
    Printed51    
    Emailed0    
    PDF Downloaded70    
    Comments [Add]    

Recommend this journal