Assessment Of The Outcomes Of Neonates With The Diagnosis Of Esophageal Atresia And/Or Tracheoesophageal Fistula Admitted To Tikur Anbessa Specialized Hospital-Neonatal Intensive Care Unit

  • MOGES AMARE
  • ABEBE HABTAMU

Abstract

Background:
Esophageal atresia and/or tracheoesophageal fistula are a fairly common congenital anomaly which is associated with serious morbidity and high rate of mortality in newborns.
Objective:
To assess the outcomes of neonates with the diagnosis of esophageal atresia and/or tracheoesophageal fistula (EA and/or TEF) admitted to Tikur Anbessa Specialized Hospital, Neonatal Intensive Care Unit (TASH-NICU) from Sep., 2008 to Aug., 2013.
Methodology:
This is a retrospective study in which clinical records of all neonates admitted to TASH-NICU with the diagnosis of EA and/or TEF from Sep., 2008 to Aug., 2013 were retrieved and those newborns whose charts had been filled with necessary information were selected as study subjects. A structured questionnaire was used to collect necessary data about each case. Outcome, possible determinant factors of outcome, associated congenital anomalies, treatment provided, and complications were analyzed.
Results:
About 41 cases of EA and/or TEF were admitted to TASH-NICU during the study period. There were 34 eligible cases. Some of the cases whose charts were lost or incompletely filled were excluded from the study. Among the eligible ones, 19 (55.9%) were females and 15 (44.1%) were males. There were only 5(14.7%) newborns that were discharged alive. Most died during the neonatal age (85.3%). Surgical intervention was performed for only half of the cases. Aspiration pneumonia was the most common reason for delayed surgical intervention. It was also the leading cause of respiratory failure and death of the newborns. There was a strong association between mortality and birth weight (P-value < 0.05).
Conclusion
This study showed that most cases of EA and/or TEF admitted to TASH-NICU died during neonatal age. Low birth weight has been strongly associated with higher risk of mortality in neonates with the diagnosis of EA and/or TEF.
Supportive care provided to newborns with EA and/ or TEF was not sufficient as it didn’t include life-saving treatments like mechanical ventilation and total parenteral nutrition.

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References

Lawn JE,Cousens S, Zupan J,2005.Neonatal Survival1: 4million neonatal deaths:When?Where?Why? The Lancet 2005 March 2; 365(9462): 891-900.
(2) Shaw-Smith C. Oesophageal atresia, tracheo-oesophageal fistula, and the VACTERL association: review of genetics and epidemiology. J Med Genet. 2006;43(7):545. (3) Engum SA, Grosfeld JL, West KW, Rescorla FJ, Scherer LR 3rd. Analysis of morbidity and mortality in 227 cases of esophageal atresia and/or tracheoesophageal fistula over two decades. Arch Surg. 1995; 130(5):502. (4) Al-Salem AH, Tayeb M, Khogair S, Roy A, Al-Jishi N, Alsenan K, Shaban H, Ahmad M. Esophageal atresia with or without tracheoesophageal fistula: success and failure in 94 cases. Ann Saudi Med. 2006 Mar-Apr;26(2):116-9. (5) Depaepe A, Dolk H, Lechat MF. The epidemiology of tracheo-oesophageal fistula and oesophageal atresia in Europe. EUROCAT Working Group. Arch Dis Child. 1993;68(6):743.
(6) Keckler SJ, St Peter SD, Valusek PA, Tsao K, Snyder CL, Holcomb GW 3rd, Ostlie DJ VACTERL anomalies in patients with esophageal atresia: an updated delineation of the spectrum and review of the literature. Pediatr Surg Int. 2007; 23(4):309. (7) LaSalle AJ, Andrassy RJ, Ver Steeg K, Ratner I. Congenital tracheoesophageal fistula without esophageal atresia. J Thorac Cardiovasc Surg. 1979;78(4):583. (8) Sparey C, Jawaheer G, Barrett AM, Robson SC. Esophageal atresia in the Northern Region Congenital Anomaly Survey, 1985-1997: prenatal diagnosis and outcome. Am J Obstet Gynecol. 2000; 182(2):427. (9) Pretorius DH, Drose JA, Dennis MA, Manchester DK, Manco-Johnson ML. Tracheoesophageal fistula in utero. Twenty-two cases. J Ultrasound Med. 1987;6(9):509. (10) Yanchar NL, Gordon R, Cooper M, Dunlap H, Soucy P. Significance of the clinical course and early upper gastrointestinal studies in predicting complications associated with repair of esophageal atresia. J Pediatr Surg. 2001;36(5):815.
Published
2014-02-01
How to Cite
AMARE, MOGES; HABTAMU, ABEBE. Assessment Of The Outcomes Of Neonates With The Diagnosis Of Esophageal Atresia And/Or Tracheoesophageal Fistula Admitted To Tikur Anbessa Specialized Hospital-Neonatal Intensive Care Unit. Ethiopian Journal of Pediatrics and Child Health, [S.l.], v. 10, n. 10, p. 55-67, feb. 2014. Available at: <http://ejol.aau.edu.et/index.php/EJPC/article/view/772>. Date accessed: 15 nov. 2018.
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