EN
TÜRKÇE
Oral Presentation - 43
Risk factors influencing the outcomes of treatment of esophageal atresia type c in Astana
Z Sakuov*, K Bauyrzhan**, D Rustemov*, V Lozovoy***, A Erekeshov****, N Zheldybayev*****, K Rysbekov***
*“University Medical Center” Corporate Fund
**University Medical Center
***Astana Medical University
****The Scientific Center of Pediatrics and Pediatric Surgery
*****Municipal multiprofile hospital No. 2 of the Astana Akimat.
Introduction. Oesophageal atresia is a complex congenital anomaly requiring surgical intervention in the neonatal period. After Kazakhstan adopted the WHO criteria for determining the viability of newborns in 2008, the number of prematurity cases requiring specialized care increased significantly.
Purpose of the study. To identify the influence of risk factors on postoperative complications, mortality and the possibility of primary anastomosis for oesophageal atresia with type C in newborns.
Materials and Methods. The study analysed clinical outcomes of 140 newborns with oesophageal atresia who were treated at University Medical Center and Municipal Multidisciplinary Hospital No. 2 in Astana, Kazakhstan, for the period 2012-2024, of which 113 patients had type C (oesophageal atresia with distal tracheo-oesophageal fistula (TEF)). To assess the impact of prematurity on mortality, severe CHD (AVSD, LHHS, etc.) and syndromes (Edwards syndrome) that directly affected mortality were excluded. After exclusion, data from 106 patients were included in the analysis. Among them 47 children were premature and 59 were preterm.
Results. Preterm infants had a 23.4% risk of death, while preterm infants had an 8.5% rate of death. Logistic regression showed that prematurity increased the risk of mortality by 3.3 times (Odds Ratio: 3.3, p=0.040), which was statistically significant (p < 0.05). Among the operated patients who underwent esophago-esophagoanastomosis (n=82), the incidence of complications (recanalisation of TEF, anastomosis leakage, stenosis of anastomosis) was similar in the groups of premature and preterm patients (7 cases in each group). Statistical analysis revealed no statistically significant influence of prematurity on the risk of complications (Odds Ratio: 2.1, p=0.214). Among 109 operated patients, oesophageal anastomosis was possible in 59% of premature (29 of 49) and 88% of preterm (53 of 60) patients. Prematurity significantly reduced the possibility of primary anastomosis (p <0.05).
Conclusions. Prematurity is a significant factor affecting the probability of mortality and the possibility of primary anastomosis, but has no statistically significant effect on the incidence of complications. This highlights the need for increased monitoring and a specialised approach to the management of premature neonates with oesophageal atresia.