UPmémoires

English

Introduction: Esophageal atresia (EA) is a rare congenital malformation. The initial surgery depends on the length of the gap. Nowadays, the survival rate of operated children is high but medium and long-term morbidity is still important. The aim of this study was to compare morbidity at 6 years between long gap esophageal atresia (LGEA) and non-long gap esophageal atresia (NLGEA).

Materials and Methods: We performed a multicentric retrospective study of patients with EA between 2008 and 2010 with a follow-up until the age of 6. For each LGEA, 2 NLGEA were included. The digestive, respiratory and orthopedic morbidity at 6 years were collected from all the medical records in association with CRACMO (Centre de Référence des Affections Chroniques et Malformatives de l'Oesophage).

Results: Thirty-one patients with LGEA and sixty-two with NLGEA were included. There were more esophagitis cases in LGEA group than in NLGEA one (45% vs 15%, p=0.005). More anti-reflux surgeries were performed in LGEA group (65% for LGEA vs 19% for NLGEA, p<0.001). LGEA group had more digestive symptoms like bolus impaction in the esophagus or dysphagia (68% vs 33%, p=0.003) and more complications such as anastomotic stricture (71% vs 38%, p=0.006). There was no significant difference between the two groups regarding respiratory symptoms. NLGEA group had more tracheomalacia than LGEA group (33% vs 6,6%, p=0.006). NLGEA group had more spine deformation than LGEA group (23% vs 3,2%, p=0.026).

Discussion: The 6-year morbidity was higher for LGEA group especially the digestive comorbidity. In the long-term, the follow-ups should be scrutinized closer for these children.

Keywords : esophageal atresia, long-gap esophageal atresia, complications, midterm outcome.