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Predictors of anastomotic strictures following œsophageal atresia repair.
- Source :
-
Archives of disease in childhood. Fetal and neonatal edition [Arch Dis Child Fetal Neonatal Ed] 2022 Sep; Vol. 107 (5), pp. 545-550. Date of Electronic Publication: 2022 Feb 25. - Publication Year :
- 2022
-
Abstract
- Objectives: To identify the risk factors for anastomotic, refractory and recurrent strictures and to establish whether anastomotic stricture is associated with antireflux surgery.<br />Design: This prospective national multicentre study included all infants born with oesophageal atresia (OA) over an 8-year period. Data on OA and complications were collected at birth and at 1 year old. Univariate and multivariate analyses were conducted.<br />Results: 1082 patients from 37 centres were included in the study. The prevalence of anastomotic stricture at 1 year old was 23.2%. Anastomosis under tension (defined by the surgeon at the time of repair) and delayed anastomosis (defined as anastomosis performed more than 15 days after birth, excluding delays due to prematurity or severe cardiac diseases) were found to be independent risk factors for anastomotic stricture (2.3 (1.42-3.74) and 4.02 (2.12-7.63), respectively). Patients with anastomotic stricture had a 2.3-fold higher rate of fundoplication compared with others (p=0.001). Anastomosis under tension and delayed anastomosis were found to be independent risk factors for recurrent stricture (1.92 (1.10-3.34) and 5.73 (2.71-12.14), respectively), while delayed anastomosis was the only risk factor for refractory stricture (8.30 (3.34-20.64)). There was a 2.39-fold (1.42-4.04) higher rate of fundoplication in the anastomotic stricture group than in the group without anastomotic stricture (p=0.001).<br />Conclusions: Patient-related anatomical factors leading to anastomosis under tension and delayed anastomosis increase the risk of anastomotic stricture.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Anastomosis, Surgical adverse effects
Constriction, Pathologic complications
Constriction, Pathologic surgery
Humans
Infant
Infant, Newborn
Postoperative Complications epidemiology
Postoperative Complications etiology
Prospective Studies
Retrospective Studies
Esophageal Atresia complications
Esophageal Stenosis epidemiology
Esophageal Stenosis etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1468-2052
- Volume :
- 107
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Archives of disease in childhood. Fetal and neonatal edition
- Publication Type :
- Academic Journal
- Accession number :
- 35217569
- Full Text :
- https://doi.org/10.1136/archdischild-2021-322577