Bal Harshjeet Singh, Sen Sudipta, Karl Sampath, Mathai John, Thomas Reju Joseph
Department of Pediatric Surgery, Christian Medical College, Vellore, India.
Department of Pediatric Surgery, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.
J Indian Assoc Pediatr Surg. 2016 Jul-Sep;21(3):131-8. doi: 10.4103/0971-9261.182588.
To evaluate the outcome of the operated children of esophageal atresia (EA) focusing on their early and late morbidity and mortality and quality of life (QoL) of survivors.
A cross-sectional follow-up with retrospective analysis of available medical and surgical records of children who underwent repair for EA.
The medical records of the children who underwent repair for EA during the period from 2000 to 2011 at the Christian Medical College Hospital, Vellore, were collected retrospectively. Patients with parents were invited to visit the hospital for follow-up and nutritional status, digestive and respiratory symptoms, status of associated anomalies and QoL assessment of children done. QoL assessment was done using the PedsQL™ 4.0 generic core scales questionnaire comprising 4 scale scores: physical, emotional, social functioning, and school functioning. Mean scores are calculated based on a 5-point response scale for each item and transformed to a 0-100 scale with a higher score representing better QoL.
Statistical Package for Social Sciences (SPSS) version 16 using Chi-square or Fisher's exact test.
Of 79 patients operated during the said period, there were 10 deaths and a total of 69 (87%) children survived. Of the 66 patients available for follow-up, we interviewed 30 parents and children while for the remaining 36 children, out-patients charts were reviewed retrospectively. Mean follow-up duration was 3.56 years. The height and weight for age measurement showed 47% and 56% of children respectively as below the 5(th) percentile. Main problems faced by operated EA children were of the respiratory (26%) and gastroesophageal (36%) tracts. In spite of the mentioned problems faced, the overall QoL of this group appeared good. In 23 of 30 patients, who answered PedsQL™, more than 70% had scores >85 out of 100 in QoL scoring.
While survivals of the children born with EA have improved, these children still face nutritional, respiratory, and gastroesophageal problems during their early childhood. In spite of this, the overall QoL of this patient group appears good.
评估食管闭锁（EA）手术患儿的预后，重点关注其早期和晚期的发病率、死亡率以及幸存者的生活质量（QoL）。
采用横断面随访，对接受EA修复手术患儿的现有医疗和手术记录进行回顾性分析。
回顾性收集2000年至2011年期间在韦洛尔基督教医学院医院接受EA修复手术患儿的病历。邀请有家长陪同的患儿到医院进行随访，并对其营养状况、消化和呼吸症状、相关畸形状况以及患儿的生活质量进行评估。生活质量评估采用儿童生活质量量表（PedsQL™）4.0通用核心量表问卷，该问卷包含4个量表得分：身体、情感、社会功能和学校功能。根据每个项目的5级反应量表计算平均分，并转换为0至100分的量表，分数越高表示生活质量越好。
使用社会科学统计软件包（SPSS）16版，采用卡方检验或Fisher精确检验。
在上述期间接受手术的79例患者中，有10例死亡，共有69例（87%）患儿存活。在66例可进行随访的患者中，我们对30例患儿的家长和患儿进行了访谈，其余36例患儿则对门诊病历进行了回顾性分析。平均随访时间为3.56年。按年龄计算的身高和体重测量结果显示，分别有47%和56%的患儿低于第5百分位。接受手术的EA患儿面临的主要问题是呼吸系统（26%）和胃食管系统（36%）。尽管存在上述问题，但该组患儿的总体生活质量看起来良好。在回答了儿童生活质量量表（PedsQL™）的30例患者中，有23例在生活质量评分中超过70%的得分高于100分中的85分。
虽然患有EA的患儿的存活率有所提高，但这些患儿在幼儿期仍面临营养、呼吸和胃食管方面的问题。尽管如此，该患者组的总体生活质量看起来良好。
