Division of Gastroenterology, Department of Pediatrics, Hôpital Sainte-Justine, Université de Montréal, Quebec, Canada.
J Pediatr. 2010 May;156(5):755-60. doi: 10.1016/j.jpeds.2009.11.038. Epub 2010 Jan 31.
To describe short- (first year of age) and long-term (after 1 year of age) outcome in patients with esophageal atresia and identify early predictive factors of morbidity in the first month of life.
Charts of children with esophageal atresia born January 1990 to May 2005 were reviewed. A complicated evolution was defined as the occurrence of at least 1 complication: severe gastroesophageal reflux, esophageal stricture requiring dilatations, recurrent fistula needing surgery, need for gavage feeding for >or=3 months, severe tracheomalacia, chronic respiratory disease, and death.
A total of 134 patients were included. Forty-nine percent of patients had a complicated evolution before 1 year of age, and 54% had a complicated evolution after 1 year. With bivariate analysis, predictive variables of a complicated evolution were demonstrated, including twin birth, preoperative tracheal intubation, birth weight <2500 g, long gap atresia, anastomotic leak, postoperative tracheal intubation >or=5 days, and inability to be fed orally by the end of the first month. After 1 year of age, the complicated evolution was only associated with long gap atresia and inability to be fed orally in the first month. A hospital stay >or=30 days was associated with a risk of a complicated evolution at 1 year and after 1 year of age (odds ratio, 9.3 [95% CI, 4.1-20.8] and 3.5 [95% CI, 1.6-7.6], respectively).
Early factors are predictive of morbidity in children with esophageal atresia.
描述食管闭锁患者的短期（1 岁以内）和长期（1 岁以后）结局，并确定出生后第一个月内发病的早期预测因素。
对 1990 年 1 月至 2005 年 5 月出生的食管闭锁患儿的病历进行回顾性分析。复杂的病程定义为至少发生以下一种并发症：严重的胃食管反流、需要扩张的食管狭窄、反复需要手术的瘘管、需要管饲喂养>或=3 个月、严重的气管软化、慢性呼吸道疾病和死亡。
共纳入 134 例患者。49%的患儿在 1 岁前病程复杂，54%的患儿在 1 岁后病程复杂。通过单变量分析，发现了一些与复杂病程相关的预测变量，包括双胞胎出生、术前气管插管、出生体重<2500g、长段食管闭锁、吻合口漏、术后气管插管>或=5 天、以及在第一个月结束时不能经口喂养。1 岁以后，只有长段食管闭锁和第一个月不能经口喂养与复杂病程相关。住院时间>或=30 天与 1 岁及 1 岁以后发生复杂病程的风险相关（比值比分别为 9.3[95%可信区间，4.1-20.8]和 3.5[95%可信区间，1.6-7.6]）。
早期因素可预测食管闭锁患儿的发病情况。
