DOZ047.45: The effect of transanastomotic feeding tubes on anastomotic strictures following esophageal atresia repair

Abstract

Abstract Purpose Recent studies have identified the use of transanastomotic tubes (TATs) as an independent risk factor for the development of strictures after repair of esophageal atresia (EA). We retrospectively analyzed a 25-year cohort of EA patients (1993–2018) to investigate the effect of TAT use on stricture formation. Methods Following institutional approval (MP-37–2019-2991), a retrospective study of all Type C and Type D EA patients who underwent primary repair was examined. Infants were included if they had surgery within the first two weeks of life and had a least one year of follow-up. Stricture was defined as the presence of symptoms confirmed by imaging and/or endoscopy. A multiple logistic regression model was used to compare stricture in those with and without TATs. Poisson regression was used to evaluate differences in postoperative outcomes listed in Table 1. Results Strictures occurred in 35 of 85 patients (41%). Of those with strictures, 25 (71%) had transanastomotic tubes. There was no significant difference in stricture rates between those with TATs and without TATs (odd ratio (OR) = 1.94, 95% confidence interval (CI): 0.78–5.06, P = 0.161). However, those who had TATs had a significantly higher number of dilations overall (rate ratio (RR) = 1.47, 95% CI: 1.09–2.03, P = 0.014). In patients with TATs, the time to enteral feeding was significantly shorter (RR = 0.37, 95% CI: 0.28–0.49, P < 0.001), but the time to oral feeding was significantly longer (RR = 1.37, CI: 1.20–1.56, P < 0.001). The TAT group had a 34% lower mean hospital length of stay. On multivariate analysis, there remained no difference in stricture rates between the two groups. Conclusion Transanastomotic tubes do not seem to result in increased strictures rates in our cohort, but significantly decrease time to initiation of enteral feeds and reduce the duration of hospital stay.