Journal of pediatric surgery · 2026
Eosinophilic esophagitis after tracheoesophageal fistula repair.
СтатьяНазвание и аннотация: Перевод в очереди
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Kahan Anastasia M, Scaife Jack H, Clinker Christopher E, Patel Raza A, Robson Jacob O, Eldredge Aidyn K, Nielsen Olivia, Kastenberg Zachary J, Russell Katie W, Short Scott S, Bucher Brian T, Scaife Eric R, Barnhart Douglas C, Traynor Michael D
Аннотация
PURPOSE: Eosinophilic esophagitis (EOE) is a known complication in children with esophageal atresia (EA) and tracheoesophageal fistula (TEF) following repair. Knowledge of EOE prevalence and characteristics among children following EA/TEF repair is limited. This study evaluates the prevalence, time to diagnosis, and clinical characteristics associated with EOE after EA/TEF repair.
METHODS: We identified a retrospective cohort of primary EA/TEF patients who underwent repair from Jan 1, 2017, to Nov 1, 2023 at a single institution. Long-term follow-up was obtained through our Esophageal and Airway Clinic (EAC) and chart review. EOE diagnosis was defined as >15 eosinophils per high-power field on endoscopic-directed biopsy.
RESULTS: Sixty-six primary EA/TEF patients who underwent repair and who also had a 1-year EGD with biopsy were included. A diagnosis of EOE was confirmed in 13 patients (19.7 %) with a mean time to diagnosis of 22 months. Postoperative outcomes after repair were largely similar across the EOE and non-EOE cohorts. 73 % (48/66) of patients underwent at least one stricture dilation postoperatively. EOE patients received significantly more dilations than non-EOE patients (median 7 vs. 2, p = 0.005). Kaplan-Meier analysis demonstrated a trend toward significantly earlier dilation among patients with EOE compared with non-EOE patients (log-rank χ2(1) = 3.82, p = 0.05).
CONCLUSION: In this large cohort of postoperative primary EA/TEF patients we found a high rate of EOE. EOE patients required earlier and more frequent stricture dilations. Our results exemplify the still-undefined physiologic interplay between the underlying pathophysiology of the esophagus after EA/TEF repair and development of EOE.
LEVEL OF EVIDENCE: III (retrospective cohort study).
METHODS: We identified a retrospective cohort of primary EA/TEF patients who underwent repair from Jan 1, 2017, to Nov 1, 2023 at a single institution. Long-term follow-up was obtained through our Esophageal and Airway Clinic (EAC) and chart review. EOE diagnosis was defined as >15 eosinophils per high-power field on endoscopic-directed biopsy.
RESULTS: Sixty-six primary EA/TEF patients who underwent repair and who also had a 1-year EGD with biopsy were included. A diagnosis of EOE was confirmed in 13 patients (19.7 %) with a mean time to diagnosis of 22 months. Postoperative outcomes after repair were largely similar across the EOE and non-EOE cohorts. 73 % (48/66) of patients underwent at least one stricture dilation postoperatively. EOE patients received significantly more dilations than non-EOE patients (median 7 vs. 2, p = 0.005). Kaplan-Meier analysis demonstrated a trend toward significantly earlier dilation among patients with EOE compared with non-EOE patients (log-rank χ2(1) = 3.82, p = 0.05).
CONCLUSION: In this large cohort of postoperative primary EA/TEF patients we found a high rate of EOE. EOE patients required earlier and more frequent stricture dilations. Our results exemplify the still-undefined physiologic interplay between the underlying pathophysiology of the esophagus after EA/TEF repair and development of EOE.
LEVEL OF EVIDENCE: III (retrospective cohort study).