CC-BY 4.0 · Surg J 2018; 04(02): e62-e65
DOI: 10.1055/s-0038-1646950
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Anastomotic Strictures after Esophageal Atresia Repair: Timing of Dilatation during the First Two Postoperative Years

Martin Salö
Division of Pediatric Surgery, Department of Clinical Sciences, Pediatrics, Lund University, and Skåne University Hospital, Lund, Sweden
,
Pernilla Stenström
Division of Pediatric Surgery, Department of Clinical Sciences, Pediatrics, Lund University, and Skåne University Hospital, Lund, Sweden
,
Magnus Anderberg
Division of Pediatric Surgery, Department of Clinical Sciences, Pediatrics, Lund University, and Skåne University Hospital, Lund, Sweden
,
Einar Arnbjörnsson
Division of Pediatric Surgery, Department of Clinical Sciences, Pediatrics, Lund University, and Skåne University Hospital, Lund, Sweden
› Author Affiliations
Further Information

Publication History

30 November 2017

12 March 2018

Publication Date:
07 May 2018 (online)

Abstract

Background We determined time frames for dilatation of anastomotic strictures (ASs) occurring during the first 2 years after esophageal atresia (EA) repair.

Methods A retrospective study was conducted on children with EA (Gross type C) who underwent direct repair between January 2008 and March 2015 at a single tertiary center of pediatric surgery. Endoscopic signs of stricture were indications for dilatation because the endoscopy provides more reliable information than X-ray imagining methods.

Results Among our cohort of 49 children with EA, 19 (39%) required at least one esophageal dilatation. All children required initial dilatation within the first year of life and none was older than 1 year during initial dilatation (p < 0.01). A median of three dilatations (range: 1–13) took place per patient, with 87% performed during the first postoperative year. The timing of initial dilatation in the first year (< 6 months, 14/19 [74%] vs. 6–12 months, 5/19 [26%]) was predictive of the need for dilatation beyond the first year (9/14 [64%] vs. 0/5 [0%]; p = 0.03) but not of more numerous dilatations (median, 3 vs. 1; p = 0.07).

Conclusion The need for dilatation within 6 months postoperatively predicts the need for dilatation after 1 year, but it does not indicate the number of dilatations that will be needed.

Note

The abstract of this manuscript was presented at the 18th European Pediatric Surgeons' Association Congress 2017.