Predictors of the Performance of Early Antireflux Surgery in Esophageal Atresia

Predictors of the Performance of Early Antireflux Surgery in Esophageal Atresia. François, B., Michaud, L., Sfeir, R., Bonnard, A., Rousseau, V., Blanc, S., Gelas, T., Boubnova, J., Jacquier, C., Irtan, S., Breton, A., Fouquet, V., Guinot, A., Lamireau, T., Habounimana, E., Schneider, A., Elbaz, F., Ranke, A., Poli-Merol, M., Kalfa, N., Dupont-Lucas, C., Petit, T., Michel, J., Buisson, P., Lirussi-Borgnon, J., Sapin, E., Lardy, H., Levard, G., Parmentier, B., Cremillieux, C., Lopez, M., Podevin, G., Schmitt, F., Borderon, C., Jaby, O., Pelatan, C., De Vries, P., Pouzac-Arnould, M., Grosos, C., Breaud, J., Laplace, C., Tolg, C., Sika, A., Auber, F., Labreuche, J., Duhamel, A., & Gottrand, F. The Journal of Pediatrics, 211:120–125.e1, August, 2019.

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OBJECTIVE: To identify predictors of and factors associated with the performance of antireflux surgery during the first year of life in children born with esophageal atresia. STUDY DESIGN: All patients were included in a French registry for esophageal atresia. All 38 multidisciplinary French centers completed questionnaires about perinatal characteristics and one-year outcome for children born with esophageal atresia. RESULTS: Of 835 infants with esophageal atresia born in France from 2010 to 2014, 682 patients, excluding those with long-gap esophageal atresia, were included. Three patients had type I, 669 had type III, and 10 had type IV esophageal atresia. Fifty-three children (7.8%) received fundoplication during the first year of life. The median age at the time of the end-to-end esophageal anastomosis was 1.1 day (range 0-15). Multivariate analysis identified three perioperative factors that predicted the need for early antireflux surgery: anastomotic tension (P = .004), associated malformations (P = .019), and low birth weight (P = .018). Six other factors, measured during the first year of life, were associated with the need for antireflux surgery: gastroesophageal reflux (P \textless .001), anastomotic stricture (P \textless .001), gastrostomy (P \textless .001), acute life-threatening event (P = .002), respiratory complications (P = .045), and poor nutritional status (P \textless .001). CONCLUSIONS: Gastroesophageal reflux disease, low birth weight, poor nutrition, and surgical anastomosis difficulties predicted the performance of antireflux surgery in the first year of life in infants with esophageal atresia.

@article{francois_predictors_2019,
	title = {Predictors of the {Performance} of {Early} {Antireflux} {Surgery} in {Esophageal} {Atresia}},
	volume = {211},
	issn = {1097-6833},
	url = {https://pubmed.ncbi.nlm.nih.gov/31072651/},
	doi = {10.1016/j.jpeds.2019.03.045},
	abstract = {OBJECTIVE: To identify predictors of and factors associated with the performance of antireflux surgery during the first year of life in children born with esophageal atresia.
STUDY DESIGN: All patients were included in a French registry for esophageal atresia. All 38 multidisciplinary French centers completed questionnaires about perinatal characteristics and one-year outcome for children born with esophageal atresia.
RESULTS: Of 835 infants with esophageal atresia born in France from 2010 to 2014, 682 patients, excluding those with long-gap esophageal atresia, were included. Three patients had type I, 669 had type III, and 10 had type IV esophageal atresia. Fifty-three children (7.8\%) received fundoplication during the first year of life. The median age at the time of the end-to-end esophageal anastomosis was 1.1 day (range 0-15). Multivariate analysis identified three perioperative factors that predicted the need for early antireflux surgery: anastomotic tension (P = .004), associated malformations (P = .019), and low birth weight (P = .018). Six other factors, measured during the first year of life, were associated with the need for antireflux surgery: gastroesophageal reflux (P {\textless} .001), anastomotic stricture (P {\textless} .001), gastrostomy (P {\textless} .001), acute life-threatening event (P = .002), respiratory complications (P = .045), and poor nutritional status (P {\textless} .001).
CONCLUSIONS: Gastroesophageal reflux disease, low birth weight, poor nutrition, and surgical anastomosis difficulties predicted the performance of antireflux surgery in the first year of life in infants with esophageal atresia.},
	language = {eng},
	journal = {The Journal of Pediatrics},
	author = {François, Berengere and Michaud, Laurent and Sfeir, Rony and Bonnard, Arnaud and Rousseau, Veronique and Blanc, Sebastien and Gelas, Thomas and Boubnova, Julia and Jacquier, Catherine and Irtan, Sabine and Breton, Anne and Fouquet, Virginie and Guinot, Audrey and Lamireau, Thierry and Habounimana, Edouard and Schneider, Anne and Elbaz, Frederic and Ranke, Aline and Poli-Merol, Marie-Laurence and Kalfa, Nicolas and Dupont-Lucas, Claire and Petit, Thierry and Michel, Jean-Luc and Buisson, Philippe and Lirussi-Borgnon, Josephine and Sapin, Emmanuel and Lardy, Hubert and Levard, Guillaume and Parmentier, Benoit and Cremillieux, Clara and Lopez, Manuel and Podevin, Guillaume and Schmitt, Françoise and Borderon, Corinne and Jaby, Olivier and Pelatan, Cecile and De Vries, Philine and Pouzac-Arnould, Myriam and Grosos, Celine and Breaud, Jean and Laplace, Christophe and Tolg, Cecilia and Sika, Anicet and Auber, Frederic and Labreuche, Julien and Duhamel, Alain and Gottrand, Frederic},
	month = aug,
	year = {2019},
	pmid = {31072651},
	keywords = {Anastomosis, Surgical, Constriction, Pathologic, Esophageal Atresia, Female, France, Fundoplication, Gastroesophageal Reflux, Gastrostomy, Humans, Infant, Infant, Low Birth Weight, Infant, Newborn, Male, Multivariate Analysis, Nutritional Status, Registries, antireflux surgery, esophageal atresia, fundoplication, gastroesophageal reflux disease, infant},
	pages = {120--125.e1},
}

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