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TÜRKÇE
Oral Presentation - 33
High prevalence of pulmonary abnormalities on chest CT and changes in pulmonary function in adult patients born with esophageal atresia: follow-up in adulthood is needed.
S Wintels*, J van de Ven**, L Visser**, A Duinisveld**, P Ciet***, H IJsselstijn*, R Wijnen*, J Vlot*, L Kamphuis**
*Department of Pediatric Surgery, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands
**Department of Pulmonology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
***Department of Radiology and Nuclear Medicine, Erasmus MC-Sophia Children’s Hospital, Rotterdam, the Netherlands
Purpose: Respiratory comorbidities are frequent in patients born with esophageal atresia (EA). Standardized pulmonary follow-up, including pulmonary function tests and chest computed tomography (CT) scans, is mentioned in guidelines and consensus statements, however it is still not routine practice. This study aims to prove the need for pulmonary long-term care in EA patients by analyzing findings from the structured Erasmus Medical Center follow-up program in adults in Rotterdam.
Method: Since 2019, the existing structured adult follow-up program for EA-patients was expanded to include pulmonology consultations, pulmonary function tests and chest CT scans. Patients who completed these examinations between January 2019 and October 2022 were included in this retrospective study.
Results: Among 182 included patients, 17 (9%) had EA type A and 154 (85%) had EA type C. The mean age at consultation was 33±11 years. Relevant chest CT abnormalities were observed in 128 patients (71%), including tracheomalacia (n=67, 39%), tracheal diverticulum (n=130, 79%), bronchiectasis (n=22, 12%) and osseous abnormalities (n=74, 41%). Pulmonary complaints were reported by 83 patients (46%), most frequently shortness of breath (n=56, 31%), frequent coughing (n=48, 27%) and sputum production (n=20, 11%). Pulmonary function test pre-bronchodilator showed a mean ± SD of SDS for TLC of -1.34 (±1.32), FEV1 of -1.74 (±1.33) and FEV1/FVC of -0.66 (±1.15). Pulmonary symptoms had a positive mild correlation with chest CT abnormalities (Pearson correlation coefficient 0.211, p=0.004), but abnormalities were also found in asymptomatic patients.
Conclusion: Given the high prevalence of respiratory complaints and CT abnormalities, a structured standardized follow-up program with pulmonology consultations is recommended for EA-patients. This program should include pulmonary function tests and chest CT-scans, since clinical symptoms do not consistently predict radiological findings.