Determining the Risk Factors for Anastomotic Stricture Development after Esophageal Atresia Repair: Results from the Turkish Esophageal Atresia Registry

Can İhsan Öztorun; Çiğdem Ulukaya Durakbaşa; Tutku Soyer; Coşkun Özcan; Binali Fırıncı; Berat Dilek Demirel; İlhan Çiftçi; Ayşe Parlak; Mustafa Onur Öztan; Gülnur Göllü Bahadır; İbrahim Akkoyun; Ayşe Karaman; Cengiz Gül; Gül Şalcı; Hüseyin İlhan; Akgün Oral; Rahşan Özcan; Seyithan Özaydın; Şeref Selçuk Kılıç; Gürsu Kıyan; Ali Onur Erdem; Osman Uzunlu; Abdullah Yıldız; Esra Özçakır; Nazile Ertürk; Başak Erginel; Tülin Öztaş; Ahmet Atıcı; Mehmet Mert; Hakan Samsum; Mehmet Ali Özen; Emrah Aydın; Serpil Sancar

doi:10.1055/a-2340-9078

European Journal of Pediatric Surgery, Table of Contents

Eur J Pediatr Surg 2024; 34(06): 550-557
DOI: 10.1055/a-2340-9078

Original Article

Determining the Risk Factors for Anastomotic Stricture Development after Esophageal Atresia Repair: Results from the Turkish Esophageal Atresia Registry

Authors

Can İhsan Öztorun

¹Department of Pediatric Surgery, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
Çiğdem Ulukaya Durakbaşa

²Department of Pediatric Surgery, Faculty of Medicine, Istanbul Medeniyet University, İstanbul, Turkey
Tutku Soyer

³Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
Coşkun Özcan

⁴Department of Pediatric Surgery, Faculty of Medicine, Ege University, İzmir, Turkey
Binali Fırıncı

⁵Department of Pediatric Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
Berat Dilek Demirel

⁶Department of Pediatric Surgery, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
İlhan Çiftçi

⁷Department of Pediatric Surgery, Faculty of Medicine, Selçuk University, Konya, Turkey
Ayşe Parlak

⁸Department of Pediatric Surgery, Faculty of Medicine, Uludağ University, Bursa, Turkey
Mustafa Onur Öztan

⁹Department of Pediatric Surgery, Faculty of Medicine, Izmir Katip Celebi University, İzmir, Turkey
Gülnur Göllü Bahadır

¹⁰Department of Pediatric Surgery, Faculty of Medicine, Ankara University, Ankara, Turkey
İbrahim Akkoyun

¹¹Department of Pediatric Surgery, Konya Education and Research Hospital, Konya, Turkey
Ayşe Karaman

¹²Department of Pediatric Surgery, University of Health Sciences Turkey, Ankara Dr Sami Ulus Children's Hospital, Ankara, Turkey
Cengiz Gül

¹³Department of Pediatric Surgery, University of Health Sciences Turkey, Zeynep Kamil Maternity and Children Health and Research Application Center, İstanbul, Turkey
Gül Şalcı

¹⁴Department of Pediatric Surgery, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
Hüseyin İlhan

¹⁵Department of Pediatric Surgery, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir Turkey
Akgün Oral

¹⁶Department of Pediatric Surgery, Dr. Behcet Uz Education and Research Hospital, Izmir, Turkey
Rahşan Özcan

¹⁷Department of Pediatric Surgery, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
Seyithan Özaydın

¹⁸Department of Pediatric Surgery, University of Health Sciences Turkey, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
Şeref Selçuk Kılıç

¹⁹Department of Pediatric Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey
Gürsu Kıyan

²⁰Department of Pediatric Surgery, Faculty of Medicine, Maramara University, Istanbul, Turkey
Ali Onur Erdem

²¹Department of Pediatric Surgery, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey
Osman Uzunlu

²²Department of Pediatric Surgery, Faculty of Medicine, Pamukkale University, Denizli, Turkey
Abdullah Yıldız

²³Department of Pediatric Surgery, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
Esra Özçakır

²⁴University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
Nazile Ertürk

²⁵Department of Pediatric Surgery, Faculty of Medicine, Muğla Sıtkı Kocaman University, Muğla, Turkey
Başak Erginel

²⁶Department of Pediatric Surgery, Faculty of Medicine, Istanbul University, Istanbul, Turkey
Tülin Öztaş

²⁷University of Health Sciences, Diyarbakır Training and Research Hospital, Diyarbakır, Turkey
Ahmet Atıcı

²⁸Department of Pediatric Surgery, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey
Mehmet Mert

²⁹Department of Pediatric Surgery, University of Health Sciences Van Training and Research Hospital, Van, Turkey
Hakan Samsum

³⁰Department of Pediatric Surgery, Private Antakya Academy Hospital, Hatay, Turkey
Mehmet Ali Özen

³¹Department of Pediatric Surgery, School of Medicine, Koç University, Istanbul, Turkey
Emrah Aydın

³²Department of Pediatric Surgery, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
Serpil Sancar

³³Department of Pediatric Surgery, Bursa City Hospital, Bursa, Turkey

Abstract

Introduction Anastomotic stricture (AS) is the second most common complication after esophageal atresia (EA) repair. We aimed to evaluate the data in the Turkish Esophageal Atresia Registry to determine the risk factors for AS development after EA repair in a large national cohort of patients.

Methods The data between 2015 and 2021 were evaluated. Patients were enrolled into two groups according to the occurrence of AS. Patients with AS (AS group) and without AS (non-AS group) were compared according to demographic and operative features, postoperative intubation status, and postoperative complications, such as anastomotic leaks, fistula recanalization, and the presence of gastroesophageal reflux (GER). A multivariable logistic regression analysis was performed to define the risk factors for the development of AS after EA repair.

Results Among the 713 cases, 144 patients (20.19%) were enrolled into the AS group and 569 (79.81%) in the non-AS group. The multivariable logistic regression showed that, being a term baby (odds ratio [OR]: 1.706; p = 0.006), having a birth weight over 2,500 g (OR: 1.72; p = 0.006), presence of GER (OR: 5.267; p < 0.001), or having a recurrent tracheoesophageal fistula (TEF, OR: 4.363; p = 0.006) were the risk factors for the development of AS.

Conclusions The results of our national registry demonstrate that 20% of EA patients developed AS within their first year of life. In patients with early primary anastomosis, birth weight greater than 2,500 g and presence of GER were risk factors for developing AS. When patients with delayed anastomosis were included, in addition to the previous risk factors, being a term baby, and having recurrent TEF also became risk factors.

Level of Evidence III.

Keywords

esophageal atresia - tracheoesophageal fistula - anastomotic strictures - risk factors

Full Text

References

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