Outcomes in esophageal atresia and tracheoesophageal fistula
Section snippets
Materials and methods
The hospital records of all infants who were admitted at BCCH, Vancouver, Canada with EA/TEF between 1984 and 2000 were reviewed. Patient demographics, presence of associated anomalies, presence of complications, and details of treatment and outcomes were examined. The major prognostic classification systems for EA/TEF were examined to determine which classification system best predicts survival rates of our patients. The groups in each classification system were compared with the Pearson χ2
Results
Over a period of 16 years (1984 to 2000), 144 infants (87 boys and 57 girls) with EA/TEF were treated at the BCCH. The mean gestational age was 37 weeks (range, 27 to 42 weeks). The average birth weight was 2,485 g (range, 745 to 4,599 g). Types of esophageal anomalies included 13 cases of pure EA (9%), 2 cases of EA with proximal TEF (1%), 119 cases of EA with distal TEF (83%), 2 cases of EA with proximal and distal TEF (1%), and 8 cases of H-type TEF (6%). Associated anomalies occurred in 74
Discussion
Preoperative prognostic classification systems are important for giving clinicians and parents a realistic prognosis for children and to compare results among institutions. In 1962, Waterston et al1 devised one of the first classification systems for EA/TEF. They compared results based on preoperative stratification of cases by severity and expected outcome. Risk factors that Waterston included were low birth weight, pneumonia, and associated congenital anomalies. He concluded that delayed
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