Successful Management of Oesophageal Atresia in Cameroon, Sub-Saharan Africa

BACKGROUND: Oesophageal atresia (EA) is the most common congenital anomaly of the oesophagus. Despite improvement of survival observed over the previous two decades in developed countries, the mortality remains very high and the management greatly challenging in resource-poor settings such as Camero...

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Autores principales: Fola, Olivier Kopong, Jemea, Bonaventure, Bayiha, Jean-Emile Emmanuel, Nonga, Bernadette Ngo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10209759/
https://www.ncbi.nlm.nih.gov/pubmed/36960510
http://dx.doi.org/10.4103/ajps.AJPS_47_21
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author Fola, Olivier Kopong
Jemea, Bonaventure
Bayiha, Jean-Emile Emmanuel
Nonga, Bernadette Ngo
author_facet Fola, Olivier Kopong
Jemea, Bonaventure
Bayiha, Jean-Emile Emmanuel
Nonga, Bernadette Ngo
author_sort Fola, Olivier Kopong
collection PubMed
description BACKGROUND: Oesophageal atresia (EA) is the most common congenital anomaly of the oesophagus. Despite improvement of survival observed over the previous two decades in developed countries, the mortality remains very high and the management greatly challenging in resource-poor settings such as Cameroon. We report our experience of management of EA in this environment, with a successful outcome. MATERIALS AND METHODS: We prospectively assessed patients diagnosed with EA and operated in January 2019, at the University Hospital Centre of Yaounde. Records were reviewed for demographics, history and physical examinations, radiological findings, surgical procedures and outcomes. The study has received approval from the Institutional Ethics Committees. RESULTS: In total, six patients (three males and three females, sex ratio, 0.5; mean age at diagnosis, 3.6 days; range, 1–7 days) were assessed. A past history of polyhydramnios was found in one patient (16.7%). All patients were classified Waterston Group A at diagnosis, with Ladd-Swenson type III atresia. Early primary repair was performed in four patients (66.7%) and delayed primary repair in two patients (33.3%). Operative repair mainly involved resection of the fistula, suture of trachea and oesophagus end-to-end anastomosis, followed by interposition of vascularised pleural flap. Patients were followed up 24 months. With one late death, the survival rate was 83.3%. CONCLUSION: Improvement has been achieved in the outcomes of neonatal surgery in Africa in the past two decades, but EA-related mortality remains relatively too high. Using simple techniques and available, reproducible equipment can improve survival in resource-poor settings.
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spelling pubmed-102097592023-05-26 Successful Management of Oesophageal Atresia in Cameroon, Sub-Saharan Africa Fola, Olivier Kopong Jemea, Bonaventure Bayiha, Jean-Emile Emmanuel Nonga, Bernadette Ngo Afr J Paediatr Surg Original Article BACKGROUND: Oesophageal atresia (EA) is the most common congenital anomaly of the oesophagus. Despite improvement of survival observed over the previous two decades in developed countries, the mortality remains very high and the management greatly challenging in resource-poor settings such as Cameroon. We report our experience of management of EA in this environment, with a successful outcome. MATERIALS AND METHODS: We prospectively assessed patients diagnosed with EA and operated in January 2019, at the University Hospital Centre of Yaounde. Records were reviewed for demographics, history and physical examinations, radiological findings, surgical procedures and outcomes. The study has received approval from the Institutional Ethics Committees. RESULTS: In total, six patients (three males and three females, sex ratio, 0.5; mean age at diagnosis, 3.6 days; range, 1–7 days) were assessed. A past history of polyhydramnios was found in one patient (16.7%). All patients were classified Waterston Group A at diagnosis, with Ladd-Swenson type III atresia. Early primary repair was performed in four patients (66.7%) and delayed primary repair in two patients (33.3%). Operative repair mainly involved resection of the fistula, suture of trachea and oesophagus end-to-end anastomosis, followed by interposition of vascularised pleural flap. Patients were followed up 24 months. With one late death, the survival rate was 83.3%. CONCLUSION: Improvement has been achieved in the outcomes of neonatal surgery in Africa in the past two decades, but EA-related mortality remains relatively too high. Using simple techniques and available, reproducible equipment can improve survival in resource-poor settings. Wolters Kluwer - Medknow 2023 2023-01-04 /pmc/articles/PMC10209759/ /pubmed/36960510 http://dx.doi.org/10.4103/ajps.AJPS_47_21 Text en Copyright: © 2023 African Journal of Paediatric Surgery https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Fola, Olivier Kopong
Jemea, Bonaventure
Bayiha, Jean-Emile Emmanuel
Nonga, Bernadette Ngo
Successful Management of Oesophageal Atresia in Cameroon, Sub-Saharan Africa
title Successful Management of Oesophageal Atresia in Cameroon, Sub-Saharan Africa
title_full Successful Management of Oesophageal Atresia in Cameroon, Sub-Saharan Africa
title_fullStr Successful Management of Oesophageal Atresia in Cameroon, Sub-Saharan Africa
title_full_unstemmed Successful Management of Oesophageal Atresia in Cameroon, Sub-Saharan Africa
title_short Successful Management of Oesophageal Atresia in Cameroon, Sub-Saharan Africa
title_sort successful management of oesophageal atresia in cameroon, sub-saharan africa
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10209759/
https://www.ncbi.nlm.nih.gov/pubmed/36960510
http://dx.doi.org/10.4103/ajps.AJPS_47_21
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