Gastro-esophageal and respiratory morbidity in children after esophageal atresia repair: a 23-year review from a single tertiary institution in Asia

Abstract Background Improved survival of neonates with esophageal atresia with/without tracheoesophageal fistula (EA/TEF) has resulted in increased prevalence gastro-esophageal and respiratory-related morbidities. However, long-term outcome data on these patients remains limited, making it difficult to substantiate any guidelines their chronic care. The purpose our study is report post-operative outcomes especially the respiratory Methods This was a retrospective review 65 (39 males, 26 females) who underwent EA/TEF repair from 1996 2019 at single tertiary institution. Follow up pertaining clinical characteristics, operative management morbidities analyzed. Results Fifty-seven (87.7%) had Gross Type-C anatomy, followed by 5(7.7%) Type-A, 1(1.5%) Type-B 1 Type-D. One patient late diagnosis H-type (Type-E). Thirteen (20%) long-gap EA. Median age first surgery day (IQR 1–2) life. All bronchoscopy index surgery. 52 non-long gap EA (LGEA) primary anastomosis, while most (76.9%) LGEA staged repair. Post-operatively, 4(6.2%) developed anastomotic leak which resolved conservative management. Three (4.6%) recurrent TEF, 2 re-do ligation. Twenty (30.8%) strictures, 15 requiring serial dilatation. Long-term burden morbidity high (63.1%; 64.6% respectively). majority ( n = 39,60%) required active follow-up for median duration 5 years 1.5–10 years). Predominant conditions were gastroesophageal reflux disease 28, 43.1%), dysphagia 20, 30.8%), infections 23, 35.3%), cough 19, 29.2%), pneumonia 29.2%). Tracheomalacia diagnosed 22(33.8%), whom tracheostomy severe disease. Overall mortality rate 10.8% 7): demised due failure, intra-operatively during Conclusion Despite successful surgical EA/TEF, demonstrated significant among survivors, thus highlighting importance multi-disciplinary care collaboration between respiratory, gastroenterology, otolaryngology specialists. Level evidence Prognostic, IV.