TITLE:
Current profile and outcome of 100 esophageal atresia patients in the Kyushu area of Japan
AUTHORS:
Nagata Kouji, Esumi Genshirou, Teshiba Risa, Kinoshita Yoshiaki, Taguchi Tomoaki
KEYWORDS:
Esophageal Atresia; Outcome; Low-Birth-Weight Infant; Congenital Heart Disease; Operation
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.3 No.3,
August
19,
2013
ABSTRACT:
Objectives: Since Spitz et al. reported the prognostic classification of esophageal atresia
(EA) patients in 1994, decades have been past and there have been many advances
in surgery and neonatology. Nevertheless, there have been very few reports according
to the recent outcome of the neonates with
EA, and otherwise, time has come to re-evaluate the credibility of
this classification. The aim of this study was to validate the recent
prognosis of the EA. Methods: Patient data were collected from 22 cooperative
facilities during the 5 year period from 2005 to 2009 in Kyushu area, Japan.
Total of 100 EA patients were retrospectively reviewed according to their
characteristics and the outcome. Patient who missed the characteristics and
outcome was excluded from the respective data. Results: Only 29.8% (28/94) was
prenatally diagnosed and 52.0 (52/100) had associated anomalies including major congenital heart disease (CHD), abnormal
chromosome, and others. According to the operation, primary anastomosis
was performed 57.0% (57/100) and the staged operation was performed 34.0%
(34/100). Survival rate in the neonatal period was 89.0% (89/ 100), and overall
survival rate was 78.0% (78/100). According to the Spitz classification, if patients
with associated anomalies were excluded, survival rate of Group 1 (>1500 g
and no CHD) was 93.8% (61/65), Group 2 (was worse as ever. The comprehensive treatment strategy for EA
patients with birth weight under 1500 g or CHD should be reconsidered to
improve the overall outcome.