Esophageal atresia: long-term interdisciplinary follow-up
Vol. 5 No. 2 (2016), Articles
Vol. 5 No. 2 (2016)

Esophageal atresia: long-term interdisciplinary follow-up

Articles
https://doi.org/10.7363/050206
Published 2016-07-09
Lidia B. Giúdici
Pedro de Elizalde Children’s Hospital, Buenos Aires, Argentina
Vivian S. Bokser
Pedro de Elizalde Children’s Hospital, Buenos Aires, Argentina
Sergio G. Golombek
Maria Fareri Children’s Hospital at Westchester Medical Center/New York Medical College, Valhalla, NY, USA
Carlos C. Castrillón
Pedro de Elizalde Children’s Hospital, Buenos Aires, Argentina
Mónica Trovato
Pedro de Elizalde Children’s Hospital, Buenos Aires, Argentina
Claudia C. Ferrario
Pedro de Elizalde Children’s Hospital, Buenos Aires, Argentina
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Keywords

esophageal atresia
long-term
interdisciplinary follow-up

How to Cite

Giúdici L. B., Bokser, V. S., Golombek, S. G., Castrillón C. C., Trovato, M., & Ferrario, C. C. (2016). Esophageal atresia: long-term interdisciplinary follow-up. Journal of Pediatric and Neonatal Individualized Medicine (JPNIM), 5(2), e050206. https://doi.org/10.7363/050206
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Abstract

Background: We provide protocolized interdisciplinary follow-up to babies born with Esophageal Atresia (EA). There are few reports in Argentina about follow-up of EA patients.

Objective: To describe outcomes in follow-up of EA patients at 1, 3 and 6 years old and to compare outcomes at age 1 with those at age 6.

Methods: Prospective, longitudinal, analytic study of the cohort of babies born with EA, admitted to the follow-up program from 11/01/03 to 10/31/14. Follow-up includes: growth (weight > 10th centile, WHO), neurology-psychomotor development, audiology, vision, genetic, mental health, surgical reintervention, phonostomatology, language, pulmonology, re-hospitalization for clinical causes, lost to follow-up. Outcomes were described at age 1, 3 and 6. We included all EA patients who had reached age 1 at the start of this study.

Results: 27 babies were admitted; 30% had long-gap EA; 18% presented VACTERL association; 23 children met inclusion criteria. Genetics  was assessed in 18 newborns (78%); a chromosomal map was performed in 11 babies; 3 had an abnormal karyotype. Mental health: 5/14 of the assessed children showed problems. Phonostomatology: 11 newborns checked (6 required treatment, 4 recovered at age 1). Pulmonologist evaluated 18 babies (7 with recurrent wheezing, 6 with moderate tracheomalacia). Gastroenterology and endoscopy: 80% presented gastroesophageal reflux (GER) grade 3-4, and 50% showed a pathologic pHmetry. Lost to follow-up: age 1, 2 (8%); age 3, 3 (17%); age 6, 3 (23%). Normal outcomes observed are the following. Age 1 – growth: 81%; neurologic-psychomotor developmental index (NPDI): 76%; audiology: 95%; vision: 85%; language: 62%; re-hospitalization for clinical causes: 38%; surgical reinterventions: 47%. Age 3 – growth: 78%; NPDI: 50%; audiology: 93%; vision: 93%; language: 43%; re-hospitalization: 35%; surgical reinterventions: 14%. Age 6 – growth: 50%; NPDI: 30%; audiology: 90%; vision: 40%; language: 50%; re-hospitalization for clinical causes: 0; surgical reinterventions: 7%.

Conclusions: Patients with EA are at risk for long-term morbidity and impairments. Long-term follow-up should be warranted for them.

https://doi.org/10.7363/050206
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