Clinical Experience of Esophageal Atresia.
- Author:
Seong Chul KIM
1
;
Dae Yeon KIM
;
Ellen Ai Rhan KIM
;
Ki Soo KIM
;
Soo Young PI
;
In Koo KIM
Author Information
1. Division of Pediatric Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Esophageal atresia
- MeSH:
Chungcheongnam-do;
Classification;
Colon;
Esophageal Atresia*;
Esophagostomy;
Female;
Fistula;
Gastrostomy;
Humans;
Infant, Low Birth Weight;
Infant, Newborn;
Survival Rate;
Tracheoesophageal Fistula;
Transplants
- From:Journal of the Korean Association of Pediatric Surgeons
2003;9(1):6-11
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
This study reviews 14 years' experience of esophageal atresia with special emphasis on the clinical profile and the outcome. From May 1989 to February 2003, 65 cases of esophageal atresia (EA) were treated at Asan Medical Center. Boys outnumbered girls 2.4 to 1. Prematutity and low birth weight were 27.7% and 38.5%. Esophageal atresia with distal tracheoesophageal fistula (TEF) was the most common type (87.7%), followed by pure EA and H type fistula. Forty-six patients (70.8%) had one or more associated anomalies, cardiac malformations were the most common. Duodenal atresia was found in 7 cases. There were 6 patients (9.2%) with VATER cluster. VACTERL cluster was present in 18 patients (27.7%), one of who fulfilled the complete syndrome. Waterston group A, B and C made up 21.5%, 40.0% and 38.5% of the total group. Surgical treatment was attempted in 63 patients and deferred in 2 who had severe associated malformations. For EA with distal TEF, primary esophago-esophagostomy was carried out in 51 cases, and division of TEF and gastrostomy in 4 cases and no operation in 2 cases. For pure EA, colonic graft was done in 2 after gastrostomy and esophagostomy, and esophago-esophagostomy was performed in 2 after gastrostomy. Two TEF was carried out in 2 cases with H type TEF. The overall survival rate was 76.9%, and survival by Waterstuon classification was 100% in group A, 80.8% in B and 60.0% in C. Thorough workup for associated anomalies, interdepartmental approach and more careful surgical decision and technique are required to improve the outcome of EA.
