Congenital Esophageal Atresia—Surgical Treatment Results in the Context of Quality of Life
09 August 2017
20 February 2018
10 April 2018 (online)
Introduction Esophageal atresia (EA) is one of the most frequent congenital malformations of the gastrointestinal tract. The aim of the study was to assess surgical treatment results in the context of the quality of life (QoL) of children after correction of EA.
Materials and Methods The data were collected among 73 patients after surgery of EA. The work diagnostic survey method was applied using authors' own questionnaire and standardized questionnaire, the PedsQL 4.0 generic core scales. Analysis of children growth was done based on World Health Organization percentile charts for body height and weight. Medical background for each patient, including demographic data, type of EA, type of delivery, the age of gestation, associated anomalies, mode of repair—primary and subsequent, if applicable, was collected from clinical records. Additional anomalies were divided into cardiac, skeletal, respiratory, renal, central nervous system, and other malformations (VACTERL association, CHARGE syndrome, trisomy chromosomes 18 and 21, and others).
Results In this study, 23% of children in the study group weighted below third percentile, 36% were born between 33rd and 37th week of gestation; 56% had at least one associated congenital anomalies. The QoL of children born before 37th week of gestational age was lower (p < 0.034) in social functioning than children born in term. The presence of concomitant anomalies does affect the overall generic QoL. No statistical correlation was found between the type of anomaly (with/without TEF) and patients' QoL.
Conclusion It seems to be needed to extend psychological care of premature infants with EA.
- 1 Sfeir R, Michaud L, Salleron J, Gottrand F. Epidemiology of esophageal atresia. Dis Esophagus 2013; 26 (04) 354-355
- 2 Pedersen RN, Calzolari E, Husby S, Garne E. ; EUROCAT Working group. Oesophageal atresia: prevalence, prenatal diagnosis and associated anomalies in 23 European regions. Arch Dis Child 2012; 97 (03) 227-232
- 3 Nassar N, Leoncini E, Amar E. , et al. Prevalence of esophageal atresia among 18 international birth defects surveillance programs. Birth Defects Res A Clin Mol Teratol 2012; 94 (11) 893-899
- 4 Śmigiel R. Wrodzone zarośnięcie przełyku – analiza wybranych czynników genetycznych oraz ocena fenotypowa pacjentów. Praca habilitacyjna. Wrocław: Akademia Medyczna; 2011
- 5 Śmigiel R, Lebioda A, Blaszczyński M. , et al. Alternations in genes expression of pathway signaling in esophageal tissue with atresia: results of expression microarray profiling. Dis Esophagus 2015; 28 (03) 229-233
- 6 Ioannides AS, Copp AJ. Embryology of oesophageal atresia. Semin Pediatr Surg 2009; 18 (01) 2-11
- 7 Deurloo JA, Ekkelkamp S, Hartman EE, Sprangers MA, Aronson DC. Quality of life in adult survivors of correction of esophageal atresia. Arch Surg 2005; 140 (10) 976-980
- 8 Gupta DK, Sharma S. Esophageal atresia: the total care in a high-risk population. Semin Pediatr Surg 2008; 17 (04) 236-243
- 9 Pinheiro PF, Simões e Silva AC, Pereira RM. Current knowledge on esophageal atresia. World J Gastroenterol 2012; 18 (28) 3662-3672
- 10 Dellenmark-Blom M, Chaplin JE, Gatzinsky V, Jönsson L, Abrahamson K. Health-related quality of life among children, young people and adults with esophageal atresia: a review of the literature and recommendations for future research. Qual Life Res 2015; 24 (10) 2433-2445
- 11 Varni JW, Burwinkle TM, Seid M, Skarr D. The PedsQL 4.0 as a pediatric population health measure: feasibility, reliability, and validity. Ambul Pediatr 2003; 3 (06) 329-341
- 12 Varni JW, Limbers CA, Burwinkle TM. Parent proxy-report of their children's health-related quality of life: an analysis of 13,878 parents' reliability and validity across age subgroups using the PedsQL 4.0 generic core scales. Health Qual Life Outcomes 2007; 5: 2
- 13 Varni JW, Limbers CA, Burwinkle TM. How young can children reliably and validly self-report their health-related quality of life? An analysis of 8,591 children across age subgroups with the PedsQL 4.0 generic core scales. Health Qual Life Outcomes 2007; 5: 1
- 14 Tobiasz-Adamczy B. Jakość życia w naukach społecznych i medycznych. Sztuka Leczenia 1996; 2: 33-40
- 15 Sroufe A, Egeland B, Carlson E, Collins A. The Development of the Person: The Minnesota Study of Risk and Adaptation from Birth to Adulthood. New York: The Guilford Press; 2005
- 16 Dingemann C, Meyer A, Kircher G. , et al. Long-term health-related quality of life after complex and/or complicated esophageal atresia in adults and children registered in a German patient support group. J Pediatr Surg 2014; 49 (04) 631-638
- 17 Dellenmark-Blom M, Chaplin JE, Gatzinsky V. , et al. Health-related quality of life experiences among children and adolescents born with esophageal atresia: development of a condition-specific questionnaire for pediatric patients. J Pediatr Surg 2016; 51 (04) 563-569
- 18 Lepeytre C, De Lagausie P, Merrot T, Baumstarck K, Oudyi M, Dubus JC. Medium-term outcome, follow-up, and quality of life in children treated for type III esophageal atresia [in French]. Arch Pediatr 2013; 20 (10) 1096-1104
- 19 Torfs CP, Curry CJ, Bateson TF. Population-based study of tracheoesophageal fistula and esophageal atresia. Teratology 1995; 52 (04) 220-232
- 20 Depaepe A, Dolk H, Lechat MF. ; EUROCAT Working Group. The epidemiology of tracheo-oesophageal fistula and oesophageal atresia in Europe. Arch Dis Child 1993; 68 (06) 743-748
- 21 Robert E, Mutchinick O, Mastroiacovo P. , et al. An international collaborative study of the epidemiology of esophageal atresia or stenosis. Reprod Toxicol 1993; 7 (05) 405-421
- 22 Chittmittrapap S, Spitz L, Kiely EM, Brereton RJ. Oesophageal atresia and associated anomalies. Arch Dis Child 1989; 64 (03) 364-368
- 23 Legrand C, Michaud L, Salleron J. , et al. Long-term outcome of children with oesophageal atresia type III. Arch Dis Child 2012; 97 (09) 808-811
- 24 Krishnan UK, McLennan LM, Li Chan JC. , et al. Quality of Life in Children with Eosinophilic Esophagitis Associated with Esophageal Atresia and Tracheoesophageal Fistula. Rotterdam: The 3rd International Conference on Esophageal Atresia; 2014