MD/MPH Dual-Degree Program, University of Connecticut School of Medicine, UConn John Dempsey Hospital, 100 Hospital Drive, Farmington, CT, 06030, United States.
Division of Research Operations and Development, Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT, 06106, United States.
J Pediatr Surg. 2023 Jun;58(6):1213-1218. doi: 10.1016/j.jpedsurg.2023.02.030. Epub 2023 Feb 23.
Endoscopic surveillance guidelines for patients with repaired esophageal atresia (EA) rely primarily on expert opinion. Prior to embarking on a prospective EA surveillance registry, we sought to understand EA surveillance practices within the Eastern Pediatric Surgery Network (EPSN).
An anonymous, 23-question Qualtrics survey was emailed to 181 physicians (surgeons and gastroenterologists) at 19 member institutions. Likert scale questions gauged agreement with international EA surveillance guideline-derived statements. Multiple-choice questions assessed individual and institutional practices.
The response rate was 77%. Most respondents (80%) strongly agree or agree that EA surveillance endoscopy should follow a set schedule, while only 36% claimed to perform routine upper GI endoscopy regardless of symptoms. Many institutions (77%) have an aerodigestive clinic, even if some lack a multi-disciplinary EA team. Most physicians (72%) expressed strong interest in helping develop evidence-based guidelines.
Our survey reveals physician agreement with current guidelines but weak adherence. Surveillance methods vary greatly, underscoring the lack of evidence-based data to guide EA care. Aerodigestive clinics may help implement surveillance schedules. Respondents support evidence-based protocols, which bodes well for care standardization. Results will inform the first multi-institutional EA databases in the United States (US), which will be essential for evidence-based care.
This is a prognosis study with level 4 evidence.
修复后的食管闭锁（EA）患者的内镜监测指南主要依赖专家意见。在开展 EA 监测登记研究之前，我们旨在了解东部儿科外科学会网络（EPSN）内的 EA 监测实践。
我们向 19 个成员机构的 181 名医生（外科医生和胃肠病学家）发送了一份匿名的 23 个问题的 Qualtrics 调查。李克特量表问题衡量了对国际 EA 监测指南衍生陈述的同意程度。多项选择题评估了个人和机构的做法。
应答率为 77%。大多数受访者（80%）强烈同意或同意 EA 监测内窥镜检查应遵循既定时间表，而只有 36%的受访者声称无论有无症状，都要进行常规上消化道内窥镜检查。许多机构（77%）设有呼吸道诊所，尽管有些机构缺乏多学科的 EA 团队。大多数医生（72%）对帮助制定循证指南表示强烈兴趣。
我们的调查显示，医生对现行指南的认同，但遵从性较弱。监测方法差异很大，突显出缺乏循证数据来指导 EA 护理。呼吸道诊所可能有助于实施监测计划。受访者支持循证方案，这对护理标准化是有利的。研究结果将为美国首个多机构 EA 数据库提供信息，这对循证护理至关重要。
这是一项预后研究，证据水平为 4 级。
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