EN
TÜRKÇE
Poster - 42
Very Low Birth Weight Neonates and Esophageal Atresia: Primary or Delayed Esophageal-Esophageal Anastomosis? A single center experience
G Brunetti, L Valfrè, F Beati, I Capolupo, A Di Pede, F Fusaro, P Bagolan, A Conforti, A Dotta
Bambino Gesù Pediatric Hospital
Introduction:
The correction of esophageal atresia in very low birthweight (VLBW) neonates (<1500 g) is debated: immediate primary esophageal-esophageal anastomosis or ligation of the tracheoesophageal fistula with subsequent esophageal continuity reconstruction. This study compares the outcomes of the two strategies by analyzing clinical data from VLBW patients with EA in our center.
Methods:
A retrospective study of admissions from 2009 to 2024, divided into group “A”: immediate primary anastomosis; and “B”: ligation of the TEF followed by subsequent anastomosis. We analyzed auxological parameters, fistula and gap characteristics, associated malformations, survival, and short- and long-term postoperative complications. Data were analyzed using the Fisher exact test and T-test where appropriate.
Results:
23 VLBW neonates out of 280: 8/23 [group A], 15/23 [group B]. No significant differences for heart defects, gap size, or birth weight. SGA in 13/23. Two deaths in group “A” (sepsis and trisomy 18), with hospital stay in group “A” shorter than in group “B”. The frequency of postoperative complications in group “B” was higher, but not statistically significant. In the 12-month follow-up, group “B” patients required endoscopic dilation for esophageal stenosis more frequently than group “A” [p=0.0394].
Conclusions:
Immediate primary anastomosis is a safe and effective technique for VLBW neonates. Further research is needed to confirm these results in a broader clinical developmental context.