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Retrospective cohort study of long-gap oesophageal atresia

Authors

  • Rajesh Maheshwari,

    1. Grace Centre for Newborn Care, The Children's Hospital, Sydney, New South Wales, Australia
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  • Amit Trivedi,

    Corresponding author
    1. Grace Centre for Newborn Care, The Children's Hospital, Sydney, New South Wales, Australia
    • Correspondence: Dr Amit Trivedi, Grace Centre for Newborn Care, The Children's Hospital, Locked Bag 4001, Westmead, NSW 2145, Australia. Fax: +61 2 9845 0559; email: amit.trivedi@health.nsw.gov.au

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  • Karen Walker,

    1. Grace Centre for Newborn Care, The Children's Hospital, Sydney, New South Wales, Australia
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  • Andrew JA Holland

    1. Douglas Cohen Department of Paediatric Surgery, The Children's Hospital, Sydney, New South Wales, Australia
    2. Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
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  • Conflict of interest: The authors have no conflict of interest to disclose.

Abstract

Aim

Long-gap oesophageal atresia (LGOA) remains a rare variant of a relatively common congenital malformation. Objectives of this study were to review the short-term results including survival, length of stay and post-operative complications for infants with LGOA managed at a single centre in addition to their growth and neurodevelopmental assessment.

Methods

Retrospective review of the case notes of all infants admitted with oesophageal atresia to our institution from January 2001 to May 2011. Infants with LGOA were selected based on pre-defined criteria. Demographic and clinical variables and details of follow-up visits including developmental assessments were extracted from their case notes.

Results

Of 101 infants with oesophageal atresia, 15 fulfilled the criteria for LGOA. Overall survival was 80%. Median length of stay was 83 days. Additional congenital anomalies were present in nine (60%). A fall in weight centile during hospitalisation or outpatient follow-up signifying growth failure was seen in a majority with 11 of 13 patients showing this phenomenon. Follow-up at our institution ranged from 6 months to 9 years. Developmental assessments (Bayley-III) commenced in August 2006 were available in four patients (age 5–13 months) and were abnormal in all, with particular delay in the gross motor domain.

Conclusions

Infants with LGOA spend a long time in hospital. They remain at significant risk of growth failure during hospitalisation and following discharge. There appears to be a risk of developmental delay that warrants close monitoring.

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