Journal
JOURNAL OF PEDIATRIC SURGERY
Volume 54, Issue 11, Pages 2242-2249Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jpedsurg.2019.06.017
Keywords
Esophageal atresia; Long-gap; Gross type a; Grass type B; Surgical repair; Postoperative complication
Categories
Funding
- University of Southern Denmark Faculty of Health and Science
- Surgical Department A, Odense University Hospital
- Research Foundation of Odense University Hospital, Denmark
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Background: The surgical repair of long-gap esophageal atresia (LGEA) is still a challenge and there is no consensus on the preferred method of reconstruction. We performed a systematic review of the surgical treatment of LGEA Gross type A and B with the primary aim to compare the postoperative complications related to the different methods within the first postoperative year. Methods: Systematic literature review on the surgical repair of LGEA Gross type A and B within the first year of life published from January 01, 1996 to November 01, 2016. Results: We included 57 artides involving a total of 326 patients of whom 289 had a Gross type A LGEA. Delayed primary anastomosis (DPA) was the most applied surgical method (68.4%) in both types, followed by gastric pull-up (GPU) (83%). Anastomotic stricture (53.7%), gastro-esophageal reflux (GER) (32.2%) and anastomotic leakage (22.7%) were the most common postoperative complications, with stricture and GER occurring more often after DPA (61.9% and 40.8% respectively) compared to other methods (p < 0.001). Conclusion: The majority of patients in this review were managed by DPA and postoperative complications were common despite the surgical method, with anastomotic stricture and GER being most common after DPA. (C) 2019 Elsevier Inc. All rights reserved.
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