Universität zu Köln

Troebs, R. B., Finke, W., Bahr, M., Roll, C., Nissen, M., Vandad, M. R. and Cernaianu, G. (2017). Isolated tracheoesophageal fistula versus esophageal atresia - Early morbidity and short-term outcome. A single institution series. Int. J. Pediatr. Otorhinolaryngol., 94. S. 104 - 112. CLARE: ELSEVIER IRELAND LTD. ISSN 1872-8464

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Abstract

Purpose: We compared the postnatal course, morbidity and early results after repair for cases of isolated or pure TEF with those for cases of esophageal atresia (EA) with distal tracheoesophageal fistula (TEF). Methods: Twenty-four consecutive infants were divided into two groups: isolated TEF [TEF group] (n = 5) and EA with distal TEF [EA group] (n = 19). Results. A high rate of prematurity (29%) and major cardiac and other surgically-relevant malformations (0.8 vs. 0.7 per infant) was found in both groups. The median age at surgery was 8 days for the TEF group vs. 1 day for the EA group (p < 0.01). Most infants of both cohorts had stable acid-base and respiratory parameters at admission. Generally, tracheoscopy provided valuable information regarding the position of the TEF. Surgery for isolated TEF was performed via right cervicotomy in 4 cases and via thoracotomy in one. Postoperative thoracostomy tubes were inserted in 3 cases and one emergency gastrostomy was created for acute gastric overextension (exclusively in patients with EA). The duration of postoperative mechanical ventilation (49 vs. 113 h, p = 0.045) and the median length of stay in the pediatric surgery unit (10 vs. 20.5 days, p = 0.003) were shorter for the isolated TEF group. Four EA patients experienced severe events. Total mortality was 8% (0 out of 5 with TEF vs. 2 out of 19 with EA). Conclusion: Developmental delay and a high rate of morbidity were found in both groups. More complex surgery increased perioperative morbidity in cases of EA. With early recognition of isolated TEF, a less complicated course can be expected in comparison with esophageal atresia. (C) 2017 The Authors. Published by Elsevier Ireland Ltd.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Troebs, R. B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Finke, W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bahr, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Roll, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nissen, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vandad, M. R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cernaianu, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-237671
DOI:	10.1016/j.ijporl.2017.01.022
Journal or Publication Title:	Int. J. Pediatr. Otorhinolaryngol.
Volume:	94
Page Range:	S. 104 - 112
Date:	2017
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1872-8464
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PRENATAL-DIAGNOSIS; INFANTS; BIRTH; PREVALENCE; MANAGEMENT; NEWBORNS; SPECTRUM; REPAIR Multiple languages Otorhinolaryngology; Pediatrics Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/23767