Esophageal atresia and transitional care--step 1: a systematic review and meta-analysis of the literature to define the prevalence of chronic long-term problems.

BACKGROUND

Esophageal atresia (EA) is a rare congenital anomaly with high infantile survival rates. The aim of this study was to outline the prevalence of common long-term problems associated with EA repair in patients older than 10 years of age.

DATA SOURCES: Original papers were identified by systematic searching of MEDLINE and EMBASE databases from January 1993 to July 2014. Fifteen articles (907 EA patients) met inclusion criteria.

CONCLUSIONS

This is the first systematic review aiming to quantify the prevalence of the long-term problems associated with EA. The main active medical conditions (pooled estimated prevalence) identified were the following: dysphagia (50.3%), gastroesophageal reflux disease with (40.2%) or without (56.5%) histological esophagitis, recurrent respiratory tract infections (24.1%), doctor-diagnosed asthma (22.3%), persistent cough (14.6%), and wheeze (34.7%). The prevalence of Barrett's esophagus (6.4%) was 4 and 26 times higher than the adult (1.6%) and pediatric (.25%) general populations. Adult and pediatric practitioners should focus on how to develop effective long-term follow-up and transitional care for these patients.