EN
TÜRKÇE
Poster - 22
Long-gap Esophageal Atresia: Beyond Surgical Correction. A Longitudinal Prospective Comparative Follow-up Study until 2 Years of Age
L Valfrè
Ospedale Pediatrico Bambino Gesù, Roma, Italy
Aim:
Long-gap esophageal atresia (LGEA) is a complex condition with poorly defined long-term outcomes. While surgical correction has been extensively studied, late complications remain underexplored. This study aimed to assess outcomes up to two years of age in infants treated for LGEA at a tertiary referral center.
Methods:
We conducted a longitudinal prospective study including all esophageal atresia (EA) patients treated between January 2010 and December 2020. LGEA was defined as a preoperative gap exceeding three vertebral bodies. Patients were followed in a multidisciplinary outpatient clinic, with data collected on growth, neurological development, esophageal dilations, reoperations, antireflux procedures, and hospital readmissions.
Results:
The study included 137 non-long-gap (NLG) and 67 long-gap (LG) EA patients. At two years, LG patients had significantly lower weight (median 10.4 kg vs. 11 kg, p=0.01) and length (median 82 cm vs. 86.4 cm, p=0.008), and lower BMI (median 14.5 vs. 15.3, p=0.04). LG patients also showed a higher incidence of oral aversion (16% vs. 3%, p=0.001), dysphagia (52% vs. 26%, p=0.0005), and required more esophageal dilations (40% vs. 9%, p<0.0001). Antireflux surgery (25% vs. 7%, p=0.0007), reoperations (6% vs. 1%, p=0.04), and stent placements (7% vs. 1%, p=0.01) were also more common in LG patients. Other complications, such as gastroesophageal reflux, respiratory issues, and chest deformities, showed no significant differences.
Conclusions:
This is the first prospective follow-up study on LGEA patients up to two years of age. Our findings indicate that LGEA patients face a more complex postoperative course with higher rates of late complications. Early multidisciplinary care and long-term follow-up are crucial to addressing these challenges.