Evaluation of Delayed Surgical Repair of Esophageal Atresia in Patients with Distal Tracheoesophageal Fistula in Suez Canal University Hospitals | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 88, Volume 98, Issue 1, January 2025, Pages 609-614 PDF (382.23 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2025.409496 | ||
| Abstract | ||
| Background: Esophageal atresia (EA) involves complex congenital esophageal abnormalities, likely caused by disruptions in embryological foregut separation. Aim: This study aimed to evaluate delayed EA/TEF repair outcomes, focusing on morbidity, mortality, complications, short-term function, and perioperative status for effectiveness. Patients and methods: This retrospective investigation has been conducted at the Pediatric Surgery Unit, General Surgery Department at Suez Canal University Hospitals on 35 cases who had tracheoesophageal fistula (TEF). Results: Postoperative complications were categorized by repair timing in 35 cases: repair within 48 hours to one week (n=10), during the first week (n=12), after the first week but before 10 days (n=6), and after 10 days (n=7). Mortality increased with delay, peaking at 42.8% in repairs after 10 days. Pneumothorax occurred in repairs within the first week (8.3%) and after 10 days (28.5%). Strictures were highest (28.5%) in repairs after 10 days. Major anastomotic leakage occurred only after one week, while minor leakage increased with delay, reaching 71% after 10 days. Repair after the first week had higher complications than repair within the first week, though differences were insignificant (p > 0.05). However, mortality was significantly higher in repairs after the first week (p=0.019). Conclusion: The timing of esophageal atresia and tracheoesophageal fistula repair is crucial for outcomes. Early repair reduces complications, while delayed repair increases risks but allows stabilization. Misdiagnosis at birth due to inadequate prenatal detection raises complication risks. A study found 30/35 survival, with 5 deaths. Complications were higher in delayed repair cases. | ||
| Keywords | ||
| TEF; EA; Strictures; Pneumothorax | ||
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