Long-term burden of care and radiation exposure in survivors of esophageal atresia

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• 作者：Paul Zamiara^a ; ^{pzamiara2016@meds.uwo.ca" class="auth_mail" title="E-mail the corresponding author} ; Karen E. Thomas^b ; ^{karen.thomas@sickkids.ca" class="auth_mail" title="E-mail the corresponding author} ; Bairbre L. Connolly^b ; ^{bairbre.connolly@sickkids.ca" class="auth_mail" title="E-mail the corresponding author} ; Hillary Lane^c ; ^{lanehillary@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Margaret A. Marcon^c ; ^{peggy.marcon@sickkids.ca" class="auth_mail" title="E-mail the corresponding author} ; Priscilla P. Chiu^a ; ^{priscilla.chiu@sickkids.ca" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Esophageal atresia ; Tracheoesophageal fistula ; Morbidity ; Long-term follow up ; Radiation exposure ; Chronic disease
• 刊名：Journal of Pediatric Surgery
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：50
• 期：10
• 页码：1686-1690
• 全文大小：235 K

文摘

Patients with esophageal atresia with or without tracheoesophageal fistula (EA/TEF) historically have had a high risk of neonatal mortality but the majority of patients are now expected to live into adulthood. However, the long-term burden of care among recent EA/TEF survivors has not been documented.

Methods

A single-institution retrospective review of newborns with EA/TEF treated from 2001-2005 was conducted, including initial and total hospitalization length of stay, and number of clinic visits and procedures requiring general anesthesia in the first three years of life. Exposure to and number of radiological studies involving ionizing radiation (IR) were recorded.

Results

Seventy-one of 78 (91%) patients survived to discharge and 69 were included for analysis. Mean length of initial hospital stay was 51.3 (range 9-390) days. By age 3 years, patients required 4.5 (mean, range 1-23) procedures performed under general anesthesia, attended 13.5 (mean, range 3-40) outpatient visits and were exposed to 17.4 mSv (mean, range 3.0-59.9) of IR from 40 (mean, range 5-165) radiological studies.

Conclusion

Patients with EA/TEF need complex and frequent hospital-based care from infancy to early childhood. Opportunities to critically review clinical services and imaging needs should be explored to improve the experience of patients and their families.