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Oesophageal Atresia without Major Cardiovascular Anomalies: Is Management Justified at a District Paediatric Surgical Institution?
BACKGROUND: Oesophageal atresia lacks sufficiently documented treatment approach, as guidelines are based rather on the opinion of experts than on systematic data. We aimed to answer the question if treatment of patients without major cardiovascular anomalies could be justified at a peripheral paedi...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8109746/ https://www.ncbi.nlm.nih.gov/pubmed/33595544 http://dx.doi.org/10.4103/ajps.AJPS_113_20 |
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author | Sinopidis, Xenophon Athanasopoulou, Maria Panagidis, Antonios Koletsis, Efstratios Karkoulias, Kiriakos Georgiou, George |
author_facet | Sinopidis, Xenophon Athanasopoulou, Maria Panagidis, Antonios Koletsis, Efstratios Karkoulias, Kiriakos Georgiou, George |
author_sort | Sinopidis, Xenophon |
collection | PubMed |
description | BACKGROUND: Oesophageal atresia lacks sufficiently documented treatment approach, as guidelines are based rather on the opinion of experts than on systematic data. We aimed to answer the question if treatment of patients without major cardiovascular anomalies could be justified at a peripheral paediatric surgical institution, by evaluating the outcome of surgical correction. METHODS: Thirty-three neonates underwent surgery for correction of oesophageal atresia during a period of 20 years. They were categorised into two time-period groups, to follow-up the evolution of surgical intervention and complications through time. Evaluation of post-operative outcome and morbidity was performed. The results were related to those of our recent cross-sectional study on families having experienced oesophageal atresia performed years after repair, regarding the long-term quality of life. RESULTS: A shift from staged to primary repair occurred throughout time in the patients with a marginal long gap between proximal and distal oesophagus (P = 0.008). Anastomotic stenosis was the major short-term complication encountered, treated with postoperative dilation sessions. Dysphagia and reflux were the most common long-term complications. CONCLUSIONS: Oesophageal atresia without severe cardiovascular abnormalities could be treated at a peripheral paediatric surgical department with satisfactory outcomes. However, qualified paediatric surgeons, anaesthesiologists and neonatologists and the availability of neonatal intensive care unit should be definitively required. |
format | Online Article Text |
id | pubmed-8109746 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-81097462021-05-18 Oesophageal Atresia without Major Cardiovascular Anomalies: Is Management Justified at a District Paediatric Surgical Institution? Sinopidis, Xenophon Athanasopoulou, Maria Panagidis, Antonios Koletsis, Efstratios Karkoulias, Kiriakos Georgiou, George Afr J Paediatr Surg Original Article BACKGROUND: Oesophageal atresia lacks sufficiently documented treatment approach, as guidelines are based rather on the opinion of experts than on systematic data. We aimed to answer the question if treatment of patients without major cardiovascular anomalies could be justified at a peripheral paediatric surgical institution, by evaluating the outcome of surgical correction. METHODS: Thirty-three neonates underwent surgery for correction of oesophageal atresia during a period of 20 years. They were categorised into two time-period groups, to follow-up the evolution of surgical intervention and complications through time. Evaluation of post-operative outcome and morbidity was performed. The results were related to those of our recent cross-sectional study on families having experienced oesophageal atresia performed years after repair, regarding the long-term quality of life. RESULTS: A shift from staged to primary repair occurred throughout time in the patients with a marginal long gap between proximal and distal oesophagus (P = 0.008). Anastomotic stenosis was the major short-term complication encountered, treated with postoperative dilation sessions. Dysphagia and reflux were the most common long-term complications. CONCLUSIONS: Oesophageal atresia without severe cardiovascular abnormalities could be treated at a peripheral paediatric surgical department with satisfactory outcomes. However, qualified paediatric surgeons, anaesthesiologists and neonatologists and the availability of neonatal intensive care unit should be definitively required. Wolters Kluwer - Medknow 2021 2021-02-16 /pmc/articles/PMC8109746/ /pubmed/33595544 http://dx.doi.org/10.4103/ajps.AJPS_113_20 Text en Copyright: © 2021 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 Sinopidis, Xenophon Athanasopoulou, Maria Panagidis, Antonios Koletsis, Efstratios Karkoulias, Kiriakos Georgiou, George Oesophageal Atresia without Major Cardiovascular Anomalies: Is Management Justified at a District Paediatric Surgical Institution? |
title | Oesophageal Atresia without Major Cardiovascular Anomalies: Is Management Justified at a District Paediatric Surgical Institution? |
title_full | Oesophageal Atresia without Major Cardiovascular Anomalies: Is Management Justified at a District Paediatric Surgical Institution? |
title_fullStr | Oesophageal Atresia without Major Cardiovascular Anomalies: Is Management Justified at a District Paediatric Surgical Institution? |
title_full_unstemmed | Oesophageal Atresia without Major Cardiovascular Anomalies: Is Management Justified at a District Paediatric Surgical Institution? |
title_short | Oesophageal Atresia without Major Cardiovascular Anomalies: Is Management Justified at a District Paediatric Surgical Institution? |
title_sort | oesophageal atresia without major cardiovascular anomalies: is management justified at a district paediatric surgical institution? |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8109746/ https://www.ncbi.nlm.nih.gov/pubmed/33595544 http://dx.doi.org/10.4103/ajps.AJPS_113_20 |
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