بررسی مشکلات همراه و عوارض تنفسی بعد از ترمیم آترزی مری در بیمارستان حضرت علی اصغر تهران از سال 1374 تا 1389

  Background : Esophageal atresia is a common congenital malformation which it’s various forms dispose patients to short term and long term complications with different rates of frequency and types of complications.   Methods : The present study was designed to consider these complications as well as associated anomalies in pediatric cases who were operated since 1995 to 2009 in Aliasghar Children Hospital in Tehran. First, all cases were studied through a chart review in terms of demographic, delivery history as well as types and rates of complications. As a follow up component, growth status and present general health status were checked by a follow up visit or calling the families. Findings were presented in terms of frequency and rates using SPSS software (version 16).   Results : A total of 66 patients were studied during follow up period (minimum 2 and maximum 15.5 years). Thirty eight (57.5%) cases were female, 42 (64%) were born low birth weight, 33 were premature (50%), and 14 had low APGAR score at birth (23%). Atresia was common in 58 cases (88%) and 28 (44%) showed associated anomalies, most commonly GI (13 cases, 20%) and cardiac (10 cases, 15%). Some 9 cases developed short term respiratory complication postoperatively (29%) including aspiration pneumonia, pneumothorax, lung collapse and anastomosis leak. Long term complications including respiratory and non respiratory ones leading to admission were developed in 139 episodes amongst them. Various pneumonias, lung collapse, gastroesophageal reflux, esophageal stricture and persistent wheezing were more frequent. Twenty one cases passed away (31%) during follow up period, 62% of remainder showed normal growth.   Conclusion : In spite of similarities concerning complication rates in this study comparing other studies, it was showed that there is a need to have a shared protocol for various specialists in order to yield earlier detection of associated problems, better applications of diagnostic imaging methods for anatomical evaluation of respiratory system and pulmonary function test, and also best practice parameters for prevention and treatment of respiratory infections and growth monitoring if their quality of life is to be improved.