Esophageal Atresia Associated with Congenital Duodenal Obstruction: Turkish Esophageal Atresia Registry (TEAR) Evaluation
Küçük Resim Yok
Tarih
2024
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Georg Thieme Verlag Kg
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Introduction Coexistent congenital duodenal obstruction and esophageal atresia (EA) is known to have significant morbidity and mortality. Management strategies are not well-defined for this association. The data fromthe Turkish EA registry is evaluated. Materials and Methods A database search was done for the years 2015 to 2022. Results Among 857 EA patients, 31 (3.6%) had congenital duodenal obstruction. The mean birth weight was 2,104 (+/- 457) g with 6 babies weighing less than 1,500 g. Twenty-six (84%) had type C EA. The duodenal obstruction was complete in 15 patients and partial in 16. Other anomalies were detected in 27 (87%) patients. VACTERL-H was present in 15 (48%), anorectal malformation in 10 (32%), amajor cardiacmalformation in 6 (19%), and trisomy-21 in 3 (10%). Duodenal obstruction diagnosiswas delayed in 10 ( 32%) babies for a median of 7.5 (1-109) days. Diagnosis for esophageal pathologies was delayed in 2. Among 19 babies with a simultaneous diagnosis, 1 died without surgery, 6 underwent triple repair for tracheoesophageal fistula (TEF), EA, and duodenal obstruction, and 3 for TEF and duodenal obstruction in the same session. A staged repair was planned in the remaining 9 patients. In total, 15 ( 48%) patients received a gastrostomy, the indication was long-gap EA in 8. Twenty-five (77%) patients survived. The cause of mortality was sepsis (n = 3) and major cardiac malformations (n = 3). Conclusion Congenital duodenal obstruction associated with EA is a complex problem. Delayed diagnosis is common. Management strategies regarding singlestage repairs or gastrostomy insertions vary notably depending on the patient characteristics and institutional preferences.
Açıklama
Anahtar Kelimeler
esophageal atresia, duodenal atresia, management, surgery, outcome
Kaynak
European Journal of Pediatric Surgery
WoS Q Değeri
Q2
Scopus Q Değeri
Q2
Cilt
34
Sayı
1
