Taylor Andrew C F, Breen Kerry J, Auldist Alex, Catto-Smith Anthony, Clarnette Tom, Crameri Joe, Taylor Russell, Nagarajah Satish, Brady Jocelyn, Stokes Keith
Gastroenterology Department, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
Clin Gastroenterol Hepatol. 2007 Jun;5(6):702-6. doi: 10.1016/j.cgh.2007.03.012.
BACKGROUND & AIMS: Esophageal atresia (EA) is the most common congenital anomaly of the esophagus. There are few long-term follow-up data on adults who had surgery for EA as infants. The primary aims were to evaluate the prevalence of esophageal symptoms and pathology and second to develop recommendations for follow-up.
This is a descriptive study of individuals attending a clinic in an adult tertiary referral hospital, established to provide care for adults who had surgery for EA as infants. Individuals aged 20 years or older were identified from an existing database and invited by telephone to attend the clinic. One hundred thirty-two patients attended the clinic from 2000-2003. Individuals were assessed by using a structured questionnaire. Endoscopy was performed in 62 patients because of symptoms.
Reflux symptoms were reported by 83 (63%), including 25 (19%) with severe symptoms. Dysphagia was reported by 68 patients (52%). Of those who underwent endoscopy, reflux esophagitis was present in 36 patients (58%), Barrett's esophagus in 7 (11%), and strictures in 26 (42%) patients. One patient was diagnosed with esophageal squamous cell carcinoma. Men who were 35 years or older and individuals with severe reflux symptoms were at high risk of having severe esophagitis or Barrett's metaplasia.
Reflux symptoms, esophagitis, and Barrett's esophagus are common in these individuals. We recommend clinical assessment as adults and upper endoscopy for reflux symptoms or dysphagia. Transition of young adults from pediatric care to an adult gastroenterology clinic with expertise in EA appears to be highly beneficial.
食管闭锁（EA）是最常见的先天性食管畸形。关于婴儿期接受EA手术的成年人的长期随访数据较少。主要目的是评估食管症状和病理的发生率，其次是制定随访建议。
这是一项对在一家成人三级转诊医院的诊所就诊的个体进行的描述性研究，该诊所专为婴儿期接受EA手术的成年人提供护理。从现有数据库中识别出年龄在20岁及以上的个体，并通过电话邀请他们到诊所就诊。2000年至2003年期间有132名患者到诊所就诊。使用结构化问卷对个体进行评估。62名有症状的患者接受了内镜检查。
83名患者（63%）报告有反流症状，其中25名（19%）症状严重。68名患者（52%）报告有吞咽困难。在接受内镜检查的患者中，36名（58%）有反流性食管炎，7名（11%）有巴雷特食管，26名（42%）有狭窄。1名患者被诊断为食管鳞状细胞癌。35岁及以上的男性和有严重反流症状的个体患严重食管炎或巴雷特化生的风险较高。
这些个体中反流症状、食管炎和巴雷特食管很常见。我们建议对成年人进行临床评估，对于有反流症状或吞咽困难的患者进行上消化道内镜检查。将年轻成年人从儿科护理过渡到具有EA专业知识的成人胃肠病诊所似乎非常有益。
