Title

Acid suppression duration does not alter anastomotic stricture rates after esophageal atresia with distal tracheoesophageal fistula repair: A prospective multi-institutional cohort study.

Document Type

Article

Publication Date

6-2022

Identifier

DOI: 10.1016/j.jpedsurg.2022.02.004

Abstract

Introduction: Anastomotic stricture is the most common complication after esophageal atresia (EA) repair. We sought to determine if postoperative acid suppression is associated with reduced stricture formation.

Methods: A prospective, multi-institutional cohort study of infants undergoing primary EA repair from 2016 to 2020 was performed. Landmark analysis and multivariate Cox regression were used to explore if initial duration of acid suppression was associated with stricture formation at hospital discharge (DC), 3-, 6-, and 9-months postoperatively.

Results: Of 156 patients, 79 (51%) developed strictures and 60 (76%) strictures occurred within three months following repair. Acid suppression was used in 141 patients (90%). Landmark analysis showed acid suppression was not associated with reduction in initial stricture formation at DC, 3-, 6- and 9-months, respectively (p = 0.19-0.95). Multivariate regression demonstrated use of a transanastomotic tube was significantly associated with stricture formation at DC (Hazard Ratio (HR) = 2.21 (95% CI 1.24-3.95, p<0.01) and 3-months (HR 5.31, 95% CI 1.65-17.16, p<0.01). There was no association between acid suppression duration and stricture formation.

Conclusion: No association between the duration of postoperative acid suppression and anastomotic stricture was observed. Transanastomotic tube use increased the risk of anastomotic strictures at hospital discharge and 3 months after repair.

Journal Title

Journal of pediatric surgery

Volume

57

Issue

6

First Page

975

Last Page

980

MeSH Keywords

Anastomosis, Surgical; Cohort Studies; Constriction, Pathologic; Esophageal Atresia; Esophageal Stenosis; Humans; Infant; Postoperative Complications; Prospective Studies; Retrospective Studies; Tracheoesophageal Fistula; Treatment Outcome

Keywords

Acid suppression; Anastomotic stricture; Esophageal atresia; Tracheoesophageal fistula

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