A prospective study outcome of surgical intervention of EA and TOF in neonate coming to paediatric surgery division of general surgery at my hospital, Indore

Abstract

Background: Esophageal atresia (EA) with or without Tracheoesophageal fistula (TEF) is most common congenital anomalies encountered in pediatric surgery and the management of these neonates require high degree of skill, manpower and tertiary care. This clinical study was undertaken to evaluate the outcome and postoperative complication of Esophageal atresia (EA) with or without Tracheoesophageal fistula (TEF) admitted in pediatrics surgery in M.Y. Hospital Indore.Objective: The aims of this study cases of EA and TEF regarding management and outcome.Methods: This prospective study included 220 patients of EA with TEF were enrolled in this study from Sep. 2016 to august 2018 who underwent surgical intervention. Their clinical profile, time of presentation, sex distribution, birth weight, type of EA and TEF and their effect on mortality and morbidity were observed.Results: Mortality was high (68.42%) among patients who reached the tertiary centre late i.e. >24 hours. The incidence of low birth weight babies is approximately 74% and mortality rate increased with low birth weight. EA with or without TEF More common in male then female but survival rate was high in female (71.60%). Type C was the most common (71.42) followed by type A. Septicemia and leak were most common complication. The mortality in septicemia patients is high 90.66%. Early surgical intervention improved the survival of EA and TEF. The overall survival rate was 48.63% and mortality was 51.36%. Conclusions: Esophageal atresia (EA) with Tracheoesophageal fistula (TEF) is the most common type of anomaly. Maturity, birth weight, early diagnosis are the most important factors that affect the outcome. Remarkable success has been achieved based on improvement in neonatal anesthesia & surgical technique, ventilator support & neonatal intensive care.