Health-related quality of life following thoracoscopic repair in children with long-gap esophageal atresia.

BACKGROUND

By retaining the native esophagus and minimizing postoperative morbidity, the thoracoscopic approach contributes to improved functional outcomes for patients with esophageal atresia (EA). The aim of this study was to evaluate HRQoL-including digestive, respiratory, and feeding outcomes in children treated exclusively by a thoracoscopic approach, with a specific focus on comparing outcomes between patients with LGEA (Gross type A and B) and those with DTEF (Gross type C or D).

MATERIALS AND

METHODS

LGEA was treated using the internal traction technique with staged repair, 25 children remained (16 aged 2-7, 9 aged 8-17), the comparison group included 69 children with DTEF (34 aged 2-7, 35 aged 8-17) who underwent thoracoscopic primary anastomosis. Final EA-QOL scores, based on clinical data and validated instruments (the EA-QOL questionnaires), were evaluated predefined hypotheses, with statistical significance set at p < 0.05.

RESULTS

No significant differences were observed between LGEA and DTEF across EA-QoL domains (p>0.05). In LGEA children aged 2-7 years, the number of esophageal dilatations was negatively correlated with HRQoL in the Eating domain (r=-0.62, p=0.014) and the Physical Health and Treatment domain (r=-0.53, p=0.044). In the Eating domain, median EA-QoL scores were 78.6 for LGEA and 75 for DTEF (p=0.375). Physical Health and Treatment scores were 75 vs. 66.7 (p=0.638), and Social Isolation and Stress scores were 75 vs. 81.3 (p=0.476).

CONCLUSIONS

HRQoL in children with LGEA is comparable to DTEF, although prematurity and multiple dilatations may increase the risk of reduced HRQoL.