Department of Neonatal Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
Department of Neonatal Surgery, The Affiliated Children's Hospital of Nanchang University, Nanchang, 330006, China.
Pediatr Surg Int. 2022 Aug;38(8):1125-1130. doi: 10.1007/s00383-022-05142-x. Epub 2022 May 29.
To assess the growth status of children with recurrent tracheoesophageal fistula (rTEF), and determine the possible risk factors of growth retardation (GR).
The medical records of 83 patients with rTEF who underwent surgical repair were retrospectively analyzed. The patients were retrospectively divided into two groups according to whether they had GR. The clinical variables were compared between the GR and non-GR groups. Univariate and multivariable logistic regression analysis were performed to identify the risk factors for GR.
Eighty-three children diagnosed with rTEF were included in this study. After a median follow-up of 31.4 (19.8, 48.7) months, GR occurred in 28 patients (33.7%). Among them, six patients with only weight for age Z score (WAZ) < -2SD, five patients with only height for age Z score (HAZ) < -2SD, and six patients with only BMI for age Z score (BAZ) < -2SD, while seven patients with both WAZ and HAZ < -2SD and four patients with both WAZ, HAZ and BAZ < -2SD. Multivariate logistic regression analysis showed that birth weight, anastomotic stricture and dysphagia after rTEF repair were independent risk factors with OR of 0.325 (0.119, 0.891), 4.396 (1.451, 13.324) and 5.341 (1.153, 24.752) for GR, respectively.
GR is a common complication after rTEF repair. Birth weight, anastomotic stricture and dysphagia after rTEF repair are independent risk factors affecting growth.
评估复发性气管食管瘘（rTEF）患儿的生长状况，并确定生长迟缓（GR）的可能危险因素。
回顾性分析 83 例接受手术修复的 rTEF 患儿的病历。根据是否存在 GR，将患儿分为两组。比较 GR 组和非 GR 组的临床变量。采用单因素和多因素逻辑回归分析确定 GR 的危险因素。
本研究共纳入 83 例诊断为 rTEF 的患儿。中位随访 31.4（19.8，48.7）个月后，28 例（33.7%）患儿发生 GR。其中，6 例患儿仅体重年龄 Z 评分（WAZ）< -2SD，5 例患儿仅身高年龄 Z 评分（HAZ）< -2SD，6 例患儿仅体重身高 Z 评分（BAZ）< -2SD，7 例患儿同时存在 WAZ 和 HAZ < -2SD，4 例患儿同时存在 WAZ、HAZ 和 BAZ < -2SD。多因素逻辑回归分析显示，出生体重、吻合口狭窄和 rTEF 修复后吞咽困难是 GR 的独立危险因素，其 OR 值分别为 0.325（0.119，0.891）、4.396（1.451，13.324）和 5.341（1.153，24.752）。
GR 是 rTEF 修复后的常见并发症。出生体重、吻合口狭窄和 rTEF 修复后吞咽困难是影响生长的独立危险因素。
