Marinschek Sabine, Pahsini Karoline, Aguiriano-Moser Victor, Russell Marion, Plecko Barbara, Reininghaus Eva Z, Till Holger, Dunitz-Scheer Marguerite
Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8010, Graz, Austria.
Department of Paediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University of Graz, Auenbruggerplatz 34/2, 8010, Graz, Austria.
Eur J Pediatr. 2020 Nov;179(11):1729-1737. doi: 10.1007/s00431-020-03673-w. Epub 2020 May 15.
Children born with esophageal atresia (EA) might suffer from significant oral feeding problems which could evolve into tube dependency. The primary aim of the study was to define the outcome of tube weaning in children after successful EA repair and to compare outcomes in children with short gap/TEF (tracheoesophageal fistula) and long-gap EA. Data of 64 children (28 with short-gap EA/TEF with primary anastomosis and 36 with long-gap EA with delayed surgical repair) who participated in a standardized tube weaning program based on the "Graz model of tube weaning" (in/outpatients in an intensive 3-week program, online coaching (Netcoaching) only, or a combined 2-week intensive onsite followed by online treatment "Eating School") from 2009 to 2019 was evaluated. Sixty-one patients completed the program by transitioning to exclusive oral intake (95.3%). Three children (4.7%) were left partially weaned at the time of discharge. No significant differences could be found between short gap/TEF and long-gap EA group regarding outcomes.Conclusions: The study's findings support the efficacy of tube weaning based on the published "Graz model of tube weaning" for children born with EA/TEF and indicate the necessity of specialized tube weaning programs for these patients. What is Known: • Children with esophageal atresia/tracheoesophageal fistula often suffer from feeding problems and tube dependency. • Different tube weaning programs and outcomes have been published, but not specifically for children with EA. What is New: • Evaluation of a large sample of children referred for tube weaning after EA repair. • Most children with EA can be weaned off their feeding tubes successfully after attending a specialized tube weaning program.
患有食管闭锁（EA）的儿童可能会出现严重的经口喂养问题，进而发展为对鼻饲管的依赖。本研究的主要目的是确定EA修复成功后儿童鼻饲管撤减的结果，并比较短间隙/食管气管瘘（TEF）和长间隙EA患儿的结果。评估了2009年至2019年期间64名参与基于“格拉茨鼻饲管撤减模型”的标准化鼻饲管撤减计划的儿童的数据（28例短间隙EA/TEF患儿行一期吻合术，36例长间隙EA患儿行延迟手术修复），这些儿童参加了为期3周的强化门诊/住院计划、仅在线指导（网络指导）或为期2周的强化现场治疗后再进行在线治疗的“进食学校”。61名患者通过过渡到完全经口进食完成了该计划（95.3%）。3名儿童（4.7%）在出院时仍部分依赖鼻饲管。短间隙/TEF组和长间隙EA组在结果方面未发现显著差异。结论：本研究结果支持基于已发表的“格拉茨鼻饲管撤减模型”对EA/TEF患儿进行鼻饲管撤减的有效性，并表明为这些患者制定专门的鼻饲管撤减计划的必要性。已知信息：• 食管闭锁/食管气管瘘患儿常存在喂养问题和对鼻饲管的依赖。• 已发表了不同的鼻饲管撤减计划和结果，但未专门针对EA患儿。新发现：• 对大量EA修复后接受鼻饲管撤减的儿童样本进行评估。• 大多数EA患儿在参加专门的鼻饲管撤减计划后能够成功撤掉鼻饲管。
