Pediatric surgery international · 2026
Predictors of anastomotic leak and a risk-stratified approach to post-operative esophagograms in pediatric esophageal repair.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Leslie-Roberts Rebecca, Schuler Ethan, Cole Alexandra, Staffa Steven J, Zurakowski David, Lajoie Debra, DeGrazia Michele, Zendejas Benjamin
Аннотация
PURPOSE: Esophageal anastomotic leak (AL) is a serious complication following pediatric esophageal repair. The purpose of this study was to identify AL predictors and develop a risk-stratified guide to post-operative imaging.
METHODS: A retrospective single-center cohort study of children who underwent a post-operative esophagogram following esophageal repairs from 2018 to 2023 and at risk for AL was conducted.
RESULTS: A total of 285 esophageal repairs were performed on 256 children (median age 6.3 months). Seventeen leaks (6%) were identified and esophagograms were completed at a median of 9 days post-operative. Seven factors significantly associated with AL were identified in the univariate analysis: female sex, rescue Foker procedure, indocyanine green segmental esophageal hypoperfusion, suture line hypoperfusion, presence of a new moderate/large pneumothorax, a new moderate/large lung consolidation, and fever occurring 48 h prior to an esophagogram. Multivariable analysis identified three independent predictors: segmental hypoperfusion, presence of a new moderate/large pneumothorax, or a new moderate/large lung consolidation. Predicted probability of AL was 3%, 14%, 74%, and 90% for 0, 1, 2, and all 3 predictors present, respectively.
CONCLUSION: Findings from this study highlight the potential for post-operative imaging to have an individualized approach based on objective predictors of AL.
METHODS: A retrospective single-center cohort study of children who underwent a post-operative esophagogram following esophageal repairs from 2018 to 2023 and at risk for AL was conducted.
RESULTS: A total of 285 esophageal repairs were performed on 256 children (median age 6.3 months). Seventeen leaks (6%) were identified and esophagograms were completed at a median of 9 days post-operative. Seven factors significantly associated with AL were identified in the univariate analysis: female sex, rescue Foker procedure, indocyanine green segmental esophageal hypoperfusion, suture line hypoperfusion, presence of a new moderate/large pneumothorax, a new moderate/large lung consolidation, and fever occurring 48 h prior to an esophagogram. Multivariable analysis identified three independent predictors: segmental hypoperfusion, presence of a new moderate/large pneumothorax, or a new moderate/large lung consolidation. Predicted probability of AL was 3%, 14%, 74%, and 90% for 0, 1, 2, and all 3 predictors present, respectively.
CONCLUSION: Findings from this study highlight the potential for post-operative imaging to have an individualized approach based on objective predictors of AL.