New Children´s Hospital, Section of Paediatric Surgery, University of Helsinki, Stenbackinkatu 9 00290 PO Box 281, Helsinki, Finland.
New Children´s Hospital, Section of Paediatric Surgery, University of Helsinki, Stenbackinkatu 9 00290 PO Box 281, Helsinki, Finland.
J Pediatr Surg. 2022 Feb;57(2):192-194. doi: 10.1016/j.jpedsurg.2021.10.047. Epub 2021 Nov 10.
An assessment of the clinical data and outcome of patients with oesophageal atresia (OA) with very low birth weight (VLBW) was completed.
With ethical consent, we reviewed the records of 327 successive patients with OA from 1980 to 2020. Main outcome measures survival and oesophageal repair were compared between patients with VLBW(≤1500 g) and with BW>1500 g.
Thirty-four (10%) patients had VLBW. Gross types of OA in VLBW were similar as in other patients: A (15%/7%), B (3%/3%), C (78%/82%), D (3%/4%), E (0%/7%), F (0%/1%) (p = 0.16-0.99). In VLBW the incidence of congenital heart disease (CHD) (47%) and trisomy 13/18 and Cri du Chat (15%) were higher than in BW>1500 g (23% and 1%), (p = 0.001 both). In VLBW one-month mortality was 35% vs 4% in patients with BW>1500 g (p < 0.001), overall mortality 56% and 8% (p < 0.001), respectively. Cause of one-month mortality in VLBW (12 patients) were CHD w/wo chromosomal abnormality (n = 7), cerebral hemorrhage (n = 2), gastric perforation (n = 1), anastomotic leakage (n = 1) and pulmonary hemorrhage (n = 1). Of VLBW patients 79% and of other patients 99% underwent oesophageal repair (p < 0.001). Repair in VLBW patients included early (n = 18) or delayed (n = 5) end-to-end anastomosis and reconstruction (n = 4). Anastomotic complications occurred in 24% of patients with VLBW and in 17% with BW>1500 g, (p = 0.31). From 1980-2000 to 2001-2020 survival in VLBW changed from 11% to 81% (p = 0.002). During 2001 - 2020 all VLBW patients underwent repair.
OA with VLBW had high incidence of life-threatening associated anomalies and decreased survival. Recently survival and rate of oesophageal repair have improved significantly.
评估极低出生体重（VLBW）食管闭锁（OA）患者的临床数据和结局。
在获得伦理同意的情况下，我们回顾了 1980 年至 2020 年期间连续 327 例 OA 患者的记录。主要观察指标为比较 VLBW（≤1500g）与 BW>1500g 患者的生存率和食管修复情况。
34 例（10%）患者为 VLBW。VLBW 患者的大体 OA 类型与其他患者相似：A（15%/7%）、B（3%/3%）、C（78%/82%）、D（3%/4%）、E（0%/7%）、F（0%/1%）（p=0.16-0.99）。VLBW 中先天性心脏病（CHD）（47%）和 13/18 三体和 Cri du Chat（15%）的发生率高于 BW>1500g（23%和 1%）（p=0.001 均）。VLBW 患者一个月死亡率为 35%，而 BW>1500g 患者为 4%（p<0.001），总死亡率分别为 56%和 8%（p<0.001）。VLBW 中一个月死亡的原因（12 例）为 CHD 伴/不伴染色体异常（n=7）、脑出血（n=2）、胃穿孔（n=1）、吻合口漏（n=1）和肺出血（n=1）。VLBW 患者中有 79%和其他患者中有 99%接受了食管修复（p<0.001）。VLBW 患者的修复包括早期（n=18）或延迟（n=5）端端吻合和重建（n=4）。VLBW 患者吻合口并发症发生率为 24%，BW>1500g 患者为 17%（p=0.31）。从 1980-2000 年到 2001-2020 年，VLBW 患者的生存率从 11%提高到 81%（p=0.002）。在 2001-2020 年期间，所有 VLBW 患者均接受了修复。
VLBW 合并 OA 合并威胁生命的相关畸形发生率高，生存率低。最近，生存率和食管修复率显著提高。
