Influencing factors for postoperative complications of esophageal atresia

Objective To evaluate the postoperative complications of esophageal anastomosis for esophageal atresia (EA) in children. Methods From January 2012 to August 2016, a total of 76 EA cases undergoing esophageal end-to-end anastomosis were recruited. There were 36 type Ⅲ-a and 40 type Ⅲ-b according to the Gross’ classification scheme. There were 49 boys (64.47%) and 27 girls (35.53%) with a mean birth weight range of (2 730±580) (1 380-4 300) grams and a mean age (3.79±3.81) (0.4-22) days. They were divided into two subgroups based upon complications, length of blind esophageal end and birth weight. Results All patients underwent operative esophageal correction and survived. The follow-up period was from 1 month to 4 years. Two cases were re-operated for anastomotic leakage. Among 19 cases of anastomotic stricture, 16 cases underwent endoscopic balloon dilatation at 1 month while another 3 cases with severe postoperative stenosis had excision and anastomosis of esophageal stricture at 3, 5 and 8 months. Significant differences existed between non-complicated and complicated groups in length of blind esophageal end, birth weight and cardiovascular malformation. However, no significant difference existed in operative age (3.12±2.24 vs 1.86±1.46 days) or average operative duration (135.3±27.2 vs 136.8±34.3 min). Conclusions Birth weight and length of blind esophageal end are more likely to be risk factors for complicated patients. However, complication is no significant correlation with operative duration. Key words: Esophageal atresia; Complications; Follow-up