Abstract
Introduction Gastroesophageal reflux disease (GERD) is a common morbidity after esophageal atresia
(EA) repair, and the antireflux procedure (ARP) is a way of treating GERD symptoms.
The aim of this study was to evaluate whether reflux index (Ri) and growth were improved
by ARP.
Materials and Methods Ninety-nine individuals with EA treated at the Queen Silvia Children's Hospital in
Gothenburg, Sweden, between 1997 and 2010 were followed prospectively according to
a structured care program. Twenty-four-hour pH-metry (Ri) and growth were studied
at birth, then at 1, 7, and 15 years of age. All the patients included had reached
7 years of age.
Results Preoperatively, Ri was significantly higher (32%) in the ARP than the non-ARP group
(10%). Postoperatively, no difference was seen between the groups. However, at 7 and
15 years of age, Ri was significantly higher in the ARP group than in the non-ARP
group. Weight (standard deviation scores) was significantly lower in the ARP group
at 1 and 7 years of age when compared with the non-ARP group, but these differences
were not seen at birth and at 15 years of age. In a multivariate analysis, only birth
weight remained a significant factor for low weight at 7 years of age. At 15 years
of age, no risk factors for low body weight were found.
Conclusion In the long term, ARP is not effective in reducing GERD as measured as Ri in EA patients.
The ARP group had significantly lower weight at 1 and 7 years of age than the non-ARP
group, but this was not the case at the age of 15.
Keywords
esophageal atresia - gastroesopageal reflux disease - antireflux procedures - long-term
follow-up
