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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...

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Autores principales: Sinopidis, Xenophon, Athanasopoulou, Maria, Panagidis, Antonios, Koletsis, Efstratios, Karkoulias, Kiriakos, Georgiou, George
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
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.
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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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