Abstract：
BACKGROUND: EA is the most frequent congenital esophageal malformation. Long gap EA remains a therapeutic challenge for pediatric surgeons. A case case-control prospective study from a multi-institutional national French data base was performed to assess the outcome, at age of 1 and 6 years, of long gap esophageal atresia (EA) compared with non-long gap EA/tracheo-esophageal fistula (TEF). The secondary aim was to assess whether initial treatment (delayed primary anastomosis of native esophagus vs. esophageal replacement) influenced mortality and morbidity at ages 1 and 6 years.
METHODS: A multicentric population-based prospective study was performed and included all patients who underwent EA surgery in France from January 1, 2008 to December 31, 2010. A comparative study was performed with non-long gap EA/TEF patients. Morbidity at birth, 1 year, and 6 years was assessed.
RESULTS: Thirty-one patients with long gap EA were compared with 62 non-long gap EA/TEF patients. At age 1 year, the long gap EA group had longer parenteral nutrition support and longer hospital stay and were significantly more likely to have complications both early post-operatively and before age 1 year compared with the non-long gap EA/TEF group. At 6 years, digestive complications were more frequent in long gap compared to non-long gap EA/TEF patients. Tracheomalacia was the only respiratory complication that differed between the groups. Spine deformation was less frequent in the long gap group. There were no differences between conservative and replacement groups at ages 1 and 6 years except feeding difficulties that were more common in the native esophagus group.
CONCLUSIONS: Long gap strongly influenced digestive morbidity at age 6 years.
METHODS: A multicentric population-based prospective study was performed and included all patients who underwent EA surgery in France from January 1, 2008 to December 31, 2010. A comparative study was performed with non-long gap EA/TEF patients. Morbidity at birth, 1 year, and 6 years was assessed.
RESULTS: Thirty-one patients with long gap EA were compared with 62 non-long gap EA/TEF patients. At age 1 year, the long gap EA group had longer parenteral nutrition support and longer hospital stay and were significantly more likely to have complications both early post-operatively and before age 1 year compared with the non-long gap EA/TEF group. At 6 years, digestive complications were more frequent in long gap compared to non-long gap EA/TEF patients. Tracheomalacia was the only respiratory complication that differed between the groups. Spine deformation was less frequent in the long gap group. There were no differences between conservative and replacement groups at ages 1 and 6 years except feeding difficulties that were more common in the native esophagus group.
CONCLUSIONS: Long gap strongly influenced digestive morbidity at age 6 years.
摘要：
背景：EA是最常见的先天性食管畸形。长间隙EA仍然是儿科外科医生的治疗挑战。进行了来自多机构国家法国数据库的病例对照前瞻性研究，以评估结果。在1岁和6岁时，长间隙食管闭锁（EA）与非长间隙EA/气管食管瘘（TEF）相比。次要目的是评估初始治疗是否（本地食管的延迟原发性吻合与食管置换）影响1岁和6岁时的死亡率和发病率。
方法：进行了一项基于多中心人群的前瞻性研究，纳入了2008年1月1日至2010年12月31日在法国接受EA手术的所有患者。对非长间隙EA/TEF患者进行了比较研究。出生时的发病率，1年,并评估了6年。
结果：将31例长间隙EA患者与62例非长间隙EA/TEF患者进行了比较。在1岁时，与非长间隙EA/TEF组相比,长间隙EA组的肠外营养支持时间更长,住院时间更长,并且在术后早期和1岁前发生并发症的可能性明显更高.6岁时,与非长间隙EA/TEF患者相比,长间隙患者的消化道并发症发生率更高.气管软化是两组之间唯一不同的呼吸系统并发症。长间隙组的脊柱变形频率较低。在1岁和6岁时，保守组和替代组之间没有差异，除了在天然食道组中更常见的喂养困难。
结论：长间隙强烈影响6岁时的消化系统发病率。
方法：进行了一项基于多中心人群的前瞻性研究，纳入了2008年1月1日至2010年12月31日在法国接受EA手术的所有患者。对非长间隙EA/TEF患者进行了比较研究。出生时的发病率，1年,并评估了6年。
结果：将31例长间隙EA患者与62例非长间隙EA/TEF患者进行了比较。在1岁时，与非长间隙EA/TEF组相比,长间隙EA组的肠外营养支持时间更长,住院时间更长,并且在术后早期和1岁前发生并发症的可能性明显更高.6岁时,与非长间隙EA/TEF患者相比,长间隙患者的消化道并发症发生率更高.气管软化是两组之间唯一不同的呼吸系统并发症。长间隙组的脊柱变形频率较低。在1岁和6岁时，保守组和替代组之间没有差异，除了在天然食道组中更常见的喂养困难。
结论：长间隙强烈影响6岁时的消化系统发病率。
