Abstract
Background: To determine the possible risk factors of recurrent tracheoesophageal fistula (rTEF) after Gross type C esophageal atresia (EA) and tracheoesophageal fistula (TEF) repair.Methods: The medical records of 343 pediatric patients with Gross type C EA/TEF who underwent surgical repair were retrospectively analyzed. The patients were retrospectively divided into two groups according to whether they had rTEF. Univariate and multivariable logistic regression analysis were performed to identify risk factors for rTEF.Results: After the diagnosis of EA/TEF, 343 patients (221 boys) underwent primary repairs after birth. According to the follow-up results (257 patients survived, 42 died, and 43 were lost to follow-up), 259 patients (257 survived and two died after rTEF repair) were included in the analysis. rTEF occurred in 33 patients (33/259, 12.74%), with a median onset time to recurrence of 3.8 (2.2, 8.2) months. Multivariate analysis showed that closing the original TEF with ligation and hospital stay ≥ 28.5 days were significant risk factors of rTEF with OR of 4.083 (1.481, 11.261) and 3.228 (1.431, 7.282).Conclusions: Surgical closure technique of original TEF and the length of initial stay could influence the occurrence of rTEF after Gross type C EA/TEF repair.
Highlights
Esophageal atresia (EA) and tracheoesophageal fistula (TEF) is one of the most common congenital malformations of the esophagus, with an incidence of 1/2500 – 1/4500 [1]
Thirteen patients died in hospital after surgical repair of EA/TEF, two died after Recurrent tracheoesophageal fistula (rTEF) surgery, one died of perforation after dilation procedure, and one died of cardiac abnormalities
According to the follow-up results, 259 patients (257 survived and two died after rTEF repair) were included in the analysis of risk factors of rTEF. rTEF occurred in 33 patients (33/259, 12.74%), with a median onset time to recurrence of 3.8 (2.2, 8.2) months
Summary
Esophageal atresia (EA) and tracheoesophageal fistula (TEF) is one of the most common congenital malformations of the esophagus, with an incidence of 1/2500 – 1/4500 [1]. The survival rate of Gross type C EA/TEF without severe malformation reported in the relevant literature is higher than 90% [1]. Survival rate has significantly improved, the procedure still has many postoperative complications. Recurrent tracheoesophageal fistula (rTEF) occurs in 3–14% of EA/TEF repairs [2]. RTEF is difficult to diagnose and treat; complex reoperative surgery is usually required, but is associated with a high rate of secondary recurrence, morbidity, and mortality [3]. Understanding the risk factors for rTEF is crucial to prevent its occurrence. To determine the possible risk factors of recurrent tracheoesophageal fistula (rTEF) after Gross type C esophageal atresia (EA) and tracheoesophageal fistula (TEF) repair
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