Department of Pediatric Gastroenterology, Sydney Children's Hospital.
Discipline of Pediatrics, School of Women's and Children's Health, University of New South Wales, Sydney, Australia.
J Pediatr Gastroenterol Nutr. 2021 Feb 1;72(2):232-238. doi: 10.1097/MPG.0000000000002945.
The aim of this study was to assess whether clinicians approached the management of children with esophageal atresia (EA) in accordance with the 2016 European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)/North American Society of Paediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) guidelines on the management of gastrointestinal and nutritional complications in this cohort.
We invited expert physicians and surgeons closely involved in the care of children with EA (members of the International network on esophageal atresia [INoEA], ESPGHAN EA working group, French national EA registry, European pediatric surgical association (EUPSA), and European rare disease reference network [ERNICA]) to participate in an anonymous online survey containing 15 multiple choice questions concerning the management of gastrointestinal and nutritional complications in children with EA. Questions were based on the management of gastroesophageal reflux disease (GERD) dysphagia, cyanotic spells, feeding and nutrition, anastamotic strictures, and transition to adult care as detailed in the 2016 guidelines.
Median concordance with ESPGHAN/NASPHAN EA Guidelines was 69% (16-100%, SD 16%) across all responders. Areas of greatest concordance were in the fields of surveillance endoscopy and medical management of GERD. Areas for potential educational opportunities include: the differential diagnosis and appropriate investigation of dysphagia and the diagnostic evaluation of extraesophageal symptoms.
This survey highlights the importance of improving the understanding and adherence to the EA guidelines amongst clinicians involved in the care of these patients.
本研究旨在评估临床医生在管理食管闭锁（EA）患儿时是否遵循了 2016 年欧洲儿科胃肠病学、肝病学和营养学学会（ESPGHAN）/北美儿科胃肠病学、肝病学和营养学学会（NASPGHAN）关于该队列中胃肠道和营养并发症管理的指南。
我们邀请了与 EA 患儿密切相关的专家医生和外科医生（INoEA 国际网络、ESPGHAN EA 工作组、法国国家 EA 登记处、欧洲小儿外科学会（EUPSA）和欧洲罕见病参考网络[ERNICA]的成员）参与一项匿名在线调查，其中包含 15 个关于 EA 患儿胃肠道和营养并发症管理的多项选择题。这些问题基于 2016 年指南中详述的胃食管反流病（GERD）、吞咽困难、紫绀发作、喂养和营养、吻合口狭窄以及向成人护理过渡的管理。
所有应答者的 ESGPHAN/NASPGHAN EA 指南一致性中位数为 69%（16%-100%，标准差 16%）。一致性最高的领域是监测内窥镜检查和 GERD 的药物治疗。可能需要教育机会的领域包括：吞咽困难的鉴别诊断和适当检查以及食管外症状的诊断评估。
这项调查强调了提高参与这些患者治疗的临床医生对 EA 指南的理解和遵循的重要性。
