%0 Multicenter Study
%T Optimal Surgical Method and Timing for Low-birth-weight Esophageal Atresia Babies: Multi-institutional Observational Study.
%A Shimizu T
%A Takamizawa S
%A Yanai T
%A Tsugawa J
%A Torikai M
%A Uemura K
%A Ohba G
%A Takeuchi Y
%A Yokoyama S
%A Ueda S
%J J Pediatr Surg
%V 59
%N 2
%D 2024 Feb 21
%M 37957100
%F 2.549
%R 10.1016/j.jpedsurg.2023.10.013
%X <B>OBJECTIVE: </B>Previous research has shown that low birth weight is one of the risk factors for esophageal atresia. However, there remains a paucity of evidence on the timing and the treatment method.<BR><B>METHODS: </B>Data were collected using a multi-institutional observational study in 11 hospitals that performed surgeries on esophageal atresia babies whose birth weights were ≤1500 g from 2001 to 2020.<BR><B>RESULTS: </B>Of the 46 patients analyzed, median birth weight was 1233 (IQR 1042-1412) g. Within 46 cases, 19 (41%) underwent definitive esophageal anastomosis at the median of age in 8 (IQR 2-101) days. Thirteen out of 19 experienced either closure of tracheoesophageal fistula, gastrostomy, or esophageal banding at the first operation, followed by esophageal anastomosis. Seven infants, including four cases of <1000 g, underwent anastomosis after one month of age to wait for weight gain (variously 2-3000 g). Twenty-one out of 27 infants (78%) who did not receive anastomosis died within one year of age, including 21 (78 %) with major cardiac anomalies and 24 (89%) with severe chromosomal anomalies (trisomy 18). Six survivors in this group, all with trisomy 18, lived with palliative surgical treatments.<BR><B>CONCLUSIONS: </B>In our study, the definitive esophageal anastomosis was effective either at the first operation or as a later treatment after gaining weight. Although having severe anomalies, some infants receive palliative surgical treatments, and the next surgery was considered depending on their condition.<BR><B>METHODS: </B>II.