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01.12.2024 | Original Article

Analysis of gap length as a predictor of surgical outcomes in esophageal atresia with distal fistula: a single center experience

verfasst von: Miki Ishikawa, Hirofumi Tomita, Yoshifumi Ito, Ayano Tsukizaki, Kiyotomo Abe, Akihiro Shimotakahara, Naoki Shimojima, Seiichi Hirobe

Erschienen in: Pediatric Surgery International | Ausgabe 1/2024

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Abstract

Purpose

Long-gap esophageal atresia (LGEA) is still a challenge for pediatric surgery. No consensus exists as to what constitutes a long gap, and few studies have investigated the maximum gap length safely repairable by primary anastomosis. Based on surgical outcomes at a single institution, we aimed to determine the gap length in LGEA with a high risk of complications.

Methods

The medical records of 51, consecutive patients with esophageal atresia (EA) with primary repair in the early neonatal period between 2001 and 2021 were retrospectively reviewed. Three, major complications were found in the surgical outcomes: (1) anastomotic leakage, (2) esophageal stricture requiring dilatation, and (3) GERD requiring fundoplication. The predictive power of the postsurgical complications was assessed using receiver operating characteristic analysis, and the area under the curve (AUC) and the cutoff value with a specificity of > 90% were calculated.

Results

Sixteen patients (31.4%) experienced a complication. The AUC of gap length was0.90 (p < 0.001), and the gap length cutoff value was ≥ 2.0 cm for predicting any complication (sensitivity: 62.5%, specificity: 91.4%).

Conclusion

A gap length ≥ 2.0 cm was considered as defining LGEA and was associated with an extremely high complication rate after primary repair.

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Titel: Analysis of gap length as a predictor of surgical outcomes in esophageal atresia with distal fistula: a single center experience
verfasst von: Miki Ishikawa
Hirofumi Tomita
Yoshifumi Ito
Ayano Tsukizaki
Kiyotomo Abe
Akihiro Shimotakahara
Naoki Shimojima
Seiichi Hirobe
Publikationsdatum: 01.12.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 1/2024
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-024-05678-0

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Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Analysis of gap length as a predictor of surgical outcomes in esophageal atresia with distal fistula: a single center experience

Abstract

Purpose

Methods

Results

Conclusion

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Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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