The role of prophylactic chest drainage in the operative management of esophageal atresia with tracheoesophageal fistula

Saeid Aslanabadi, Masoud Jamshidi, R. Shane Tubbs, Mohammadali Mohajel Shoja

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Introduction: Anastomotic leakage and respiratory complications are among the most common and potentially life-threatening complications following the surgical repair of esophageal atresia. Controversies exist regarding the efficacy of prophylactic extrapleural chest tube (EPCT) drainage in patients who have undergone repair of esophageal atresia. Materials and methods: In this prospective study, 50 newborns with esophageal atresia and distal tracheoesophageal fistula (EA-DTEF) were randomized into two groups, with no significant differences regarding gender ratio, birth body weight and delivery status. Group 1 (n = 29) underwent a right thoracotomy and a single-stage extrapleural esophageal anastomosis. Group 2 (n = 21) received additionally an intraoperative EPCT next to the anastomosis. These groups were then compared with regard to postoperative respiratory complications (such as respiratory distress, pneumonia, pneumothorax, lung collapse, and apnea), anastomotic leakage, need for mechanical ventilation, time on mechanical ventilation, and outcome. Statistical analyses were performed with Mann-Whitney U test, Fisher's exact test, and binary logistic regression analysis. Results: The rates of respiratory complications and anastomotic leakage, need for mechanical ventilation, time on mechanical ventilation, and mortality rate were comparable between the two groups (P > 0.05). Mortality was associated with respiratory complications (P = 0.003) and anastomotic leakage (P = 0.007). Conclusion: It seems that prophylactic EPCT drainage does not decrease the early postoperative respiratory complications and mortality rates in newborns with EA-DTEF.

Original languageEnglish (US)
Pages (from-to)365-368
Number of pages4
JournalPediatric Surgery International
Volume25
Issue number4
DOIs
StatePublished - Apr 1 2009
Externally publishedYes

Fingerprint

Anastomotic Leak
Artificial Respiration
Chest Tubes
Drainage
Thorax
Esophageal Atresia
Respiratory Rate
Mortality
Newborn Infant
Pulmonary Atelectasis
Apnea
Pneumothorax
Thoracotomy
Nonparametric Statistics
Birth Weight
Pneumonia
Logistic Models
Body Weight
Regression Analysis
Prospective Studies

Keywords

  • Chest tube drainage
  • Esophageal atresia
  • Extrapleural
  • Respiratory complications
  • Tracheoesophageal fistula

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Cite this

The role of prophylactic chest drainage in the operative management of esophageal atresia with tracheoesophageal fistula. / Aslanabadi, Saeid; Jamshidi, Masoud; Tubbs, R. Shane; Mohajel Shoja, Mohammadali.

In: Pediatric Surgery International, Vol. 25, No. 4, 01.04.2009, p. 365-368.

Research output: Contribution to journalArticle

Aslanabadi, Saeid ; Jamshidi, Masoud ; Tubbs, R. Shane ; Mohajel Shoja, Mohammadali. / The role of prophylactic chest drainage in the operative management of esophageal atresia with tracheoesophageal fistula. In: Pediatric Surgery International. 2009 ; Vol. 25, No. 4. pp. 365-368.
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