Adv Pediatr Surg.  2020 Dec;26(2):54-60. 10.13029/aps.2020.26.2.54.

Do Children with Esophageal Atresia Show Worse Growth Outcomes?

• Ko D
• Lee C
• Youn JK
• Yang HB
• Kim HY

• KMID: 2525500
• DOI: http://doi.org/10.13029/aps.2020.26.2.54

Abstract

Purpose
Patients with esophageal atresia (EA) often have feeding problems due to esophageal dysmotility, gastroesophageal reflux, and dysphagia, which can delay growth in children. The purpose of this study was to investigate whether proper growth is achieved during the early childhood of patients with EA and to predict associated factors.
Methods
Clinical data of patients with EA who underwent corrective surgery between 2014 and 2017 were collected retrospectively. We analyzed a total of 17 patients who were followed up for at least two years after surgery, except for patients with long-gap and type E EA. The median follow-up period was 979.0 months. We analyzed the weight, height, and weight-forheight (WFH) as z-scores. Linear regression analysis was performed to determine the factors affecting WFH at two years of age.
Results
Of the 17 patients, 11 underwent open surgery and six underwent thoracoscopic surgery. The median time to full feeding was approximately 14 (range, 12.0–53.0) days. In patients with anastomotic stenosis, esophageal balloon dilatation was performed 1–6 times. There was no mortality in our study, and the median follow-up period was 979 days. The mean height was 49.0 cm, the mean weight at birth was 2.69 kg, and the z-scores were −0.55 and −1.44, respectively. The WFH z-score decreased from −1.66 at birth to −1.82 one week postoperatively; however, it improved to −0.2 after six months. In multivariate linear regression analysis, only WFH at birth was a significant variable for WFH at two years of age.
Conclusion
Patients with EA tend to have lower weight and WFH at birth, which worsened after surgery; however, six months after surgery, both weight and WFH recovered to the 50th percentile. The factors that influence WFH at two years of age were significantly related to WFH at birth.

Keyword

Esophageal atresia; Growth; Body weight change; Children; Malnutrition