Maestri Francesca, Morandi Anna, Ichino Martina, Fava Giorgio, Cavallaro Giacomo, Leva Ernesto, Macchini Francesco
Department of Pediatric Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy.
Biomedicines. 2022 Nov 7;10(11):0. doi: 10.3390/biomedicines10112836.
Follow-up of children born with esophageal atresia (EA) is mandatory due to high incidence of comorbidities. We evaluated endoscopic findings at follow-up of EA patients performed at our Centre according to ESPGHAN-NASPGHAN 2016 guidelines. A retrospective observational study was performed using data from January 2016 to January 2021. We included EA patients (age range: 1−18 years) who were offered a program of endoscopic and histological high gastrointestinal (GI) tract examinations as per ESPGHAN-NASPGHAN 2016 guidelines. Clinical, surgical, auxological, endoscopic, and histological data were reviewed; variables as polyhydramnios, EA type, surgical type, enteral feeding introduction age, growth data, and symptoms were correlated to endoscopic and histological findings. The population included 75 patients (47 males), with mean age of 5 ± 4 years. In 40/75 (53.3%) patients, we recorded oral feeding problems, and upper gastrointestinal or respiratory symptoms suspicious of gastroesophageal reflux. Eosinophilic esophagitis (EoE) incidence was 9/75 (12%), significantly higher than in general population (p < 0.0001), and 10/75 (13.3%) presented non-specific duodenal mucosal lesions. EoE represents a frequent comorbidity of EA, as previously known. EA is also burdened by high, never-described incidence of non-specific duodenal mucosal lesions. Embedding high GI tract biopsies in EA endoscopic follow-up should be mandatory from pediatric age.
由于合并症发生率高，食管闭锁（EA）患儿的随访是必要的。我们根据ESPGHAN-NASPGHAN 2016指南，评估了在我们中心进行的EA患者随访时的内镜检查结果。使用2016年1月至2021年1月的数据进行了一项回顾性观察研究。我们纳入了根据ESPGHAN-NASPGHAN 2016指南接受内镜和组织学上消化道（GI）道检查计划的EA患者（年龄范围：1 - 18岁）。回顾了临床、手术、体格发育、内镜和组织学数据；将羊水过多、EA类型、手术类型、肠内喂养开始年龄、生长数据和症状等变量与内镜和组织学检查结果相关联。该人群包括75例患者（47例男性），平均年龄为5±4岁。在40/75（53.3%）的患者中，我们记录到经口喂养问题以及怀疑有胃食管反流的上消化道或呼吸道症状。嗜酸性食管炎（EoE）的发生率为9/75（12%），显著高于普通人群（p < 0.0001），并且10/75（13.3%）出现了非特异性十二指肠黏膜病变。如先前所知，EoE是EA常见的合并症。EA还存在着从未描述过的高发生率的非特异性十二指肠黏膜病变。从儿童期开始，在EA内镜随访中进行上消化道活检应成为常规。
