van Hoorn Camille E, de Graaff Jurgen C, Vlot John, Wijnen Rene Mh, Stolker Robert Jan, Schnater J Marco
Department of Anesthesiology, Erasmus University Medical Centre -Sophia Children's Hospital, Rotterdam, The Netherlands; Department of Pediatric Surgery and Pediatric Intensive Care, Erasmus University Medical Centre -Sophia Children's Hospital, Rotterdam, The Netherlands.
Department of Anesthesiology, Erasmus University Medical Centre -Sophia Children's Hospital, Rotterdam, The Netherlands.
J Pediatr Surg. 2021 Dec;56(12):2192-2199. doi: 10.1016/j.jpedsurg.2021.06.004. Epub 2021 Jun 26.
Children born with esophageal atresia (EA) face comorbidities and complications often requiring surgery and anesthesia. We aimed to assess all procedures performed under general anesthesia during their first 12 years of life.
We performed a retrospective cohort study about subsequent surgeries and procedures requiring general anesthesia in children born with type C EA between January 2007 and December 2017, with follow-up to March 2019.
Of 102 eligible patients, 63 were diagnosed with comorbidities, of whom 18 had VACTERL association. Follow-up time for all patients varied between 14 months and 12 years (median 7 years). The patients underwent total 637 procedures, median 4 [IQR2-7] per patient. In the first year of life, 464 procedures were performed, in the second year 69 and in the third year 29. Thirteen patients underwent no other procedures than primary EA repair. In 57 patients, 228 dilatations were performed. Other frequently performed procedures were esophagoscopy (n=52), urologic procedures (n=44) and abdominal procedures (n=33).
Patients with EA frequently require multiple anesthetics for a variety of procedures related to the EA, complications and comorbidities. This study can help care providers when counselling parents of a patient with an EA by giving them more insight into possible procedures they can be confronted with during childhood.
食管闭锁（EA）患儿常伴有合并症和并发症，常需手术和麻醉。我们旨在评估这些患儿在出生后12年内接受全身麻醉下进行的所有手术。
我们对2007年1月至2017年12月出生的C型EA患儿后续需要全身麻醉的手术和操作进行了一项回顾性队列研究，随访至2019年3月。
102例符合条件的患者中，63例被诊断患有合并症，其中18例患有VACTERL综合征。所有患者的随访时间在14个月至12年之间（中位数7年）。患者共接受了637次手术，每位患者的中位数为4次[四分位间距2 - 7次]。在出生后的第一年，进行了464次手术，第二年69次，第三年29次。13例患者除了初次EA修复外未接受其他手术。57例患者进行了228次扩张术。其他常见的手术包括食管镜检查（n = 52）、泌尿外科手术（n = 44）和腹部手术（n = 33）。
EA患者经常需要因与EA、并发症和合并症相关的各种手术而接受多次麻醉。这项研究可以帮助医护人员在为EA患儿的父母提供咨询时，让他们更深入地了解患儿在童年时期可能面临的手术。
