Journal of Indian Association of Pediatric Surgeons
Journal of Indian Association of Pediatric Surgeons
                                                   Official journal of the Indian Association of Pediatric Surgeons                           
Year : 2008  |  Volume : 13  |  Issue : 1  |  Page : 2--6

Esophageal atresia: Factors influencing survival - Experience at an Indian tertiary centre


RK Tandon, Satendra Sharma, Shandip K Sinha, Kumar Abdul Rashid, Ravi Dube, SN Kureel, Ashish Wakhlu, JD Rawat 
 Department of Pediatric Surgery and Neonatology, King George's Medical University, Lucknow -226 003, India

Correspondence Address:
Satendra Sharma
Department of Pediatric Surgery, KGMU, Lucknow - 226 003
India

Objective: To study the clinical profile of the cases of esophageal atresia (EA) and/or tracheoesophageal fistula (TEF) and various factors affecting the surgical and early postoperative management and their outcome. Materials and Methods: A prospective analysis of 127 cases of EA from February 2004 to May 2006 was performed. Waterston prognostic criteria were used for grading. Results: EA with TEF was the commonest type in 117 cases (92%). Associated congenital anomalies were present in 52 (41%) patients, the commonest being the cardiac anomalies, which was followed by the gastrointestinal anomalies. VACTERL was found in 6 (5%) cases. Prematurity, associated congenital anomalies, gap between esophageal ends and preoperative respiratory status were the significant factors affecting the survival ( P = < 0.001). Primary extrapleural repair was the surgical approach in most of the patients. Azygos vein was preserved in 46 cases and no retropleural drainage was used in 27 cases. Staged procedures were performed in 19 cases, including 6 cases of isolated esophageal atresia. Pneumonitis and sepsis were the most common early postoperative complications (42%). Hypoxia and cardiorespiratory arrest were the most common causes of mortality (11 cases). Anastomotic leak complicated 13 cases, including 9 major and 4 minor leaks. Major leak followed by sepsis caused 7 deaths. Survival as per Waterston criteria was 100% in group A, 83% in group B and 22% in group C. Conclusion Factors affecting the survival are major or life-threatening associated anomalies, long gap, pneumonia and sepsis at presentation or that acquired during hospitalization and major leaks. The high incidence of low birth weight, delayed diagnosis, poor referral, low-socio economic status and lack of advanced neonatological back up are important contributory factors to poor outcome.


How to cite this article:
Tandon R K, Sharma S, Sinha SK, Rashid KA, Dube R, Kureel S N, Wakhlu A, Rawat J D. Esophageal atresia: Factors influencing survival - Experience at an Indian tertiary centre.J Indian Assoc Pediatr Surg 2008;13:2-6


How to cite this URL:
Tandon R K, Sharma S, Sinha SK, Rashid KA, Dube R, Kureel S N, Wakhlu A, Rawat J D. Esophageal atresia: Factors influencing survival - Experience at an Indian tertiary centre. J Indian Assoc Pediatr Surg [serial online] 2008 [cited 2019 Dec 12 ];13:2-6
Available from: http://www.jiaps.com/article.asp?issn=0971-9261;year=2008;volume=13;issue=1;spage=2;epage=6;aulast=Tandon;type=0