Multicentre Retrospective Analysis of Lung Function Impairment and Risks for Restrictive Syndrome During Childhood After Type III Esophageal Atresia Repair.

OBJECTIVES

To identify the factors that result in a restrictive ventilatory impairment during childhood following type III esophageal atresia (EA) repair.

STUDY DESIGN

A multicentre, retrospective, national cohort study was conducted on 503 patients who had undergone surgery for EA between 2008 and 2013. The results of pulmonary function tests (PFT) performed during childhood were used to compare patients with pure restrictive lung impairment to children with normal PFT. Subsequently, logistic regression was employed to ascertain potential risk factors for restrictive syndrome in type III EA.

RESULTS

The cohort comprised 503 patients, of whom 216 (42.9 %) had interpretable PFT. Among them, 63.4 % exhibited normal results, 26.9 % pure restriction, 5.1 % pure obstruction, and 4.6 % a mixed pattern. Patient-associated factors that were associated with a restrictive impairment were birth weight, Caucasian ethnicity (odds ratio (OR) 4.3 [1.2-15.4]), and the presence of neonatal heart defects (OR = 5.8). [1.9-16.9]), tracheomalacia (OR = 4.1 [1.6-10.2]) and neonatal GERD (OR = 3.1 [1.3-7.4]). The sole healthcare-associated factor was the use of respiratory crisis treatment during childhood (OR = 4.8 [1.3-18.0]), whereas neither surgical factor nor postoperative parietal thoracic deformity was associated with restriction.

CONCLUSION

In contrast to surgical approaches or chest wall abnormalities, neonatal EA-associated conditions appear to be associated with a restrictive pattern during childhood, but further prospective studies remain mandatory to validate these results.