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Introduction: Jejunoileal atresia (JIA) is a major congenital anomaly that requires surgical intervention in the neonatal period. During follow-up after surgery, there is usually a period of catch-up growth (CUG) that is sufficient for patients to regain normal weight for age. However, in some cases, CUG is inadequate. The aim of this study was to assess postoperative JIA patients to determine factors that may be associated with good CUG.Material and Methods: We retrospectively reviewed JIA patients treated at our institution by classifying them into three groups based on a comparison of postoperative weight with standard weight for healthy matched controls; that is, more than mean at 12 months after surgery (group M+), less than mean at 12 months after surgery but more than mean at 24 months after surgery because of CUG (group M-CUG+), less than mean at 24 months after surgery because there was no CUG (group M-CUG-). The following parameters were evaluated: gestational age, birth weight, sight of atresia: jejunum or ileum, length of residual small intestine, ratio of the length of residual small intestine to the predicted length of small intestine for matched gestational age (RP ratio), and duration of parenteral nutrition.Results: A total of 42 patients were reviewed and classified into group M+ (n = 13), group M-CUG+ (n = 11), and group M-CUG- (n = 18). There were no significant differences in gestational age, birth weight, and duration of parenteral nutrition between the three groups. Incidence of JIA according to site was also similar. Length of residual small intestine was not significantly different between the three groups, but RP ratios were significantly higher in M+ (84.7 ± 15.4%) and M-CUG+ (83.8 ± 17.7%) compared with M-CUG- (69.2 ± 18.1%) (p = 0.02, respectively).Conclusions: A higher RP ratio (approximately 84%) would appear to be conducive to CUG while a lower ratio (less than 70%) was not. Actual length of residual small intestine was not relevant to CUG. We recommend calculating the RP ratio in postoperative JIA patients and using 70% as a cutoff value to predict patients with poor potential for CUG who may benefit from more aggressive nutritional support to achieve normal growth. [ABSTRACT FROM AUTHOR]

Introduction The management of a recurrent tracheoesophageal fistula (RTEF) includes either open surgery (OS) or an endoscopic treatment (ET); the ideal option is unclear. We aim to comparatively review all published treatment options, and outcomes, for managing RTEF. Materials and Methods A literature search was performed using the keywords "recurrent tracheoesophageal fistula." All English language articles describing the management of RTEF in children were reviewed. A synthesis of the relevant data is presented in a descriptive form due to the heterogeneity of the included articles. Results A total of 44 papers between 1955 and 2013 described 165 patients; 57 ET and 108 OS. Of the 57 ET patients, there was an 84% success rate compared with 93.5% of 108 OS patients; the failed ET cases were all successfully treated by OS. The refistulation rate after OS was 21% and an average of 1.1 (range 1-2) procedures were required. After ET, the refistulation rate was 63% and an average of 2.1 (range 1-6) treatments were required for success; these results were reported after a maximum follow-up of 9 years and 23 years for ET and OS, respectively. The major complications after OSwere 17 (16%) leaks and 4 (3.7%) deaths, while for ET 3 (5%) suffered respiratory distress postoperatively and there was 1 (1.7%) death. Conclusion OS for RTEF has a low morbidity and mortality, a higher success rate, and requires fewer treatments than an endoscopic repair. The ideal ET is undecided but it remains a viable alternative provided treatment failures are anticipated and prompt redo treatments initiated to prevent ongoing respiratory morbidity. [ABSTRACT FROM AUTHOR]