PDF(Pubmed)
Abstract：
OBJECTIVE: to review recent literature concerning long-term health issues and transitional care in esophageal atresia (EA) patients. PubMed, Scopus, Embase and Web of Science databases were screened for studies regarding EA patients aged more than or equal to 11 years, published between August 2014 and June 2022. Sixteen studies involving 830 patients were analyzed. Mean age was 27.4 years (range 11-63). EA subtype distribution was: type C (48.8%), A (9.5%), D (1.9%), E (0.5%) and B (0.2%). 55% underwent primary repair, 34.3% delayed repair, 10.5% esophageal substitution. Mean follow-up was 27.2 years (range 11-63). Long-term sequelae were: gastro-esophageal reflux (41.4%), dysphagia (27.6%), esophagitis (12.4%), Barrett esophagus (8.1%), anastomotic stricture (4.8%); persistent cough (8.7%), recurrent infections (4.3%) and chronic respiratory diseases (5.5%). Musculo-skeletal deformities were present in 36 out of 74 reported cases. Reduced weight and height were detected in 13.3% and 6% cases, respectively. Impaired quality of life was reported in 9% of patients; 9.6% had diagnosis or raised risk of mental disorders. 10.3% of adult patients had no care provider. Meta-analysis was conducted on 816 patients. Estimated prevalences are: GERD 42.4%, dysphagia 57.8%, Barrett esophagus 12.4%, respiratory diseases 33.3%, neurological sequelae 11.7%, underweight 19.6%. Heterogeneity was substantial (> 50%). Conclusion: EA patients must continue follow-up beyond childhood, with a defined transitional-care path by a highly specialized multidisciplinary team due to the multiple long-term sequelae.
BACKGROUND: • Survival rates of esophageal atresia patients is now more than 90% thanks to the improvements in surgical techniques and intensive care, therefore patients\' needs throughout adolescence and adulthood must be taken into account.
BACKGROUND: • This review, by summarizing recent literature concerning long term sequelae of esophageal atresia, may contribute to raise awareness on the importance of defining standardized protocols of transitional and adulthood care for esophageal atresia patients.
BACKGROUND: • Survival rates of esophageal atresia patients is now more than 90% thanks to the improvements in surgical techniques and intensive care, therefore patients\' needs throughout adolescence and adulthood must be taken into account.
BACKGROUND: • This review, by summarizing recent literature concerning long term sequelae of esophageal atresia, may contribute to raise awareness on the importance of defining standardized protocols of transitional and adulthood care for esophageal atresia patients.
摘要：
目的：回顾有关食管闭锁（EA）患者长期健康问题和过渡护理的最新文献。PubMed,Scopus,Embase和WebofScience数据库筛选了有关年龄超过或等于11岁的EA患者的研究。在2014年8月至2022年6月之间发布。分析了涉及830名患者的16项研究。平均年龄为27.4岁（范围11-63）。EA亚型分布为：C型（48.8％），A（9.5%），D（1.9%），E（0.5%）和B（0.2%）。55%接受了一期修复，34.3%延迟修复,10.5%食道替代。平均随访27.2年（范围11-63）。长期后遗症是：胃食管反流（41.4％），吞咽困难（27.6%），食管炎（12.4%），Barrett食管(8.1%),吻合口狭窄(4.8%);持续咳嗽(8.7%),反复感染(4.3%)和慢性呼吸系统疾病(5.5%)。在74例报告病例中，有36例存在肌肉骨骼畸形。在13.3%和6%的病例中，体重和身高下降。分别。9％的患者报告生活质量受损；9.6％的患者被诊断为精神障碍或增加了精神障碍的风险。10.3%的成年患者没有护理提供者。对816例患者进行Meta分析。估计患病率为：GERD42.4％，吞咽困难57.8%,Barrett食管12.4%,呼吸道疾病33.3%,神经后遗症11.7%,减持19.6%。异质性很大(>50%)。结论：EA患者必须在儿童期之后继续随访，由于多个长期后遗症，由高度专业化的多学科团队确定了过渡护理路径。
背景：•由于手术技术和重症监护的改进，食管闭锁患者的生存率现在超过90%，因此，必须考虑患者在整个青春期和成年期的需求。
背景：•这篇综述，通过总结有关食管闭锁长期后遗症的最新文献，可能有助于提高对定义食管闭锁患者过渡和成年护理标准化方案的重要性的认识。
背景：•由于手术技术和重症监护的改进，食管闭锁患者的生存率现在超过90%，因此，必须考虑患者在整个青春期和成年期的需求。
背景：•这篇综述，通过总结有关食管闭锁长期后遗症的最新文献，可能有助于提高对定义食管闭锁患者过渡和成年护理标准化方案的重要性的认识。
