Journal of pediatric surgery · 2026
Do congenital heart diseases or chromosomal anomalies influence the surgical outcomes of esophagocoloplasty in esophageal atresia patients?
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Tannuri Ana Cristina Aoun, Abe Takahasi Bianca Namie, de Almeida Estrambk Gabriel, Ortega Ramos Grace Raíra, Saraiva Santos Maria Eduarda, de Lima Silva Melissa, Marques Dos Anjos Raphaela, Troici Vinicius Camargo, Reis Freitas João Luis, Tannuri Uenis
Аннотация
BACKGROUND: Esophageal atresia (EA) is frequently associated with congenital heart disease (CHD) and chromosomal anomalies, mainly Down syndrome (DS). While these conditions affect outcomes following primary repair, their specific impact on esophageal substitution procedure remains poorly defined. This study aimed to evaluate the influence of CHD and chromosomal anomalies on surgical outcomes following esophagocoloplasty for failed repair of EA patients.
METHODS: Retrospective study including patients who underwent esophagocoloplasty between January 2015 and January 2025 at a single center divided into 4 groups: HD (CHD and DS), D (isolated DS), H (isolated CHD) and C (isolated EA). Demographic, clinical and surgical data, postoperative complications, length of stay, and mortality were analyzed.
RESULTS: 105 patients were included (mean age 31.2 months; 57.1% male). VACTERL-associated anomalies were present in 53.3% of patients, with CHD being the most frequent (33.3%). DS was identified in 7.6% of the cohort. Postoperative complications occurred in 40% of cases, (87.9% minor complications). Multivariate analysis demonstrated that CHD was independently associated with impaired postoperative weight gain (OR = 3.62; p = 0.008). DS was not associated with major complications or mortality, although a trend toward an increased risk of sepsis was observed. Overall mortality was 0.95% (one case). No significant differences in the incidence of major complications among the study groups were observed.
CONCLUSIONS: CHD negatively affected postoperative nutritional recovery but did not increase major morbidity or mortality in esophagocoloplasty patients. Chromosomal anomalies did not compromise overall surgical safety, supporting the feasibility of esophagocoloplasty in this complex patient population.
METHODS: Retrospective study including patients who underwent esophagocoloplasty between January 2015 and January 2025 at a single center divided into 4 groups: HD (CHD and DS), D (isolated DS), H (isolated CHD) and C (isolated EA). Demographic, clinical and surgical data, postoperative complications, length of stay, and mortality were analyzed.
RESULTS: 105 patients were included (mean age 31.2 months; 57.1% male). VACTERL-associated anomalies were present in 53.3% of patients, with CHD being the most frequent (33.3%). DS was identified in 7.6% of the cohort. Postoperative complications occurred in 40% of cases, (87.9% minor complications). Multivariate analysis demonstrated that CHD was independently associated with impaired postoperative weight gain (OR = 3.62; p = 0.008). DS was not associated with major complications or mortality, although a trend toward an increased risk of sepsis was observed. Overall mortality was 0.95% (one case). No significant differences in the incidence of major complications among the study groups were observed.
CONCLUSIONS: CHD negatively affected postoperative nutritional recovery but did not increase major morbidity or mortality in esophagocoloplasty patients. Chromosomal anomalies did not compromise overall surgical safety, supporting the feasibility of esophagocoloplasty in this complex patient population.