Perioperative Outcomes in Neonates with Esophageal Atresia with or without Tracheoesophageal Fistula
Wiriya Maisat MD*, Nillawan Youngcharoen MD*, Niramol Tantemsapya MD**, Saowaphak Lapmahapaisan MD*
Affiliation : * Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To evaluate the perioperative outcomes in neonates undergoing surgical repair of esophageal atresia with or
without tracheoesophageal fistula (EA/TEF) and to determine the associated factors contributing to prolonged postoperative
hospital length of stay (LOS) and death.
Material and Method: The medical records of neonates diagnosed with EA/TEF who underwent surgical repairs from
January 2004 to December 2013 were retrospectively analyzed.
Results : Forty-nine patients were enrolled. Esophageal stricture, anastomotic leakage, postoperative pneumonia and atelectasis
were 25.0%, 6.3%, 27.1% and 6.3% respectively. Prematurity was the single significant risk factor for prolonged postoperative
hospital LOS using a multiple logistic regression analysis (OR 5.55, 95% CI 1.11 to 27.73, p = 0.04). Low body weight (p =
0.03), cyanotic heart disease (OR 205.00, 95% CI 11.02 to 3,813.02, p<0.01) and pre-existing endotracheal tube (OR 14.09,
95% CI 1.48 to 134.30, p = 0.021) were potential risk factors for increasing mortality according to a univariate analysis.
Consequently, there were 6 mortality cases (12.2%), mostly from pneumonia and sepsis.
Conclusion : Postoperative esophageal stricture and pneumonia in neonates undergoing EA/TEF repair were common.
Prematurity was a predictor for prolonged postoperative hospital LOS. Mortality rate increased in patients with low body
weight, pre-existing endotracheal tube and cyanotic heart disease.
Keywords : Esophageal atresia,Tracheoesophageal fistula, Neonate, Perioperative outcomes
