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 language | English (US) |
|---|---|
| Pages (from-to) | 365-368 |
| Number of pages | 4 |
| Journal | Pediatric Surgery International |
| Volume | 25 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 1 2009 |
| Externally published | Yes |
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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 journal › Article
}
TY - JOUR
T1 - The role of prophylactic chest drainage in the operative management of esophageal atresia with tracheoesophageal fistula
AU - Aslanabadi, Saeid
AU - Jamshidi, Masoud
AU - Tubbs, R. Shane
AU - Mohajel Shoja, Mohammadali
PY - 2009/4/1
Y1 - 2009/4/1
N2 - 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.
AB - 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.
KW - Chest tube drainage
KW - Esophageal atresia
KW - Extrapleural
KW - Respiratory complications
KW - Tracheoesophageal fistula
UR - http://www.scopus.com/inward/record.url?scp=63549094443&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=63549094443&partnerID=8YFLogxK
U2 - 10.1007/s00383-009-2345-7
DO - 10.1007/s00383-009-2345-7
M3 - Article
VL - 25
SP - 365
EP - 368
JO - Pediatric Surgery International
JF - Pediatric Surgery International
SN - 0179-0358
IS - 4
ER -