A different approach to leakage of esophageal atresia in children

BACKGROUND: In this study, we aimed to present the results of patients treated for esophageal leakage with a different conservative approach.
METHODS: Ninety-eight patients with esophageal atresia and tracheoesophageal fistula (EA) who underwent surgery in our clinic between February 2013 and January 2018 were retrospectively reviewed in this study. Patients’ anastomosis leakage, gestational week, gender, body weight, referral date, recovery time and stenosis were recorded. After leakage detection, the nasogastric catheter was fluoroscopically converted into a nasojejunal catheter using a guidewire and feeding continued.
RESULTS: Anastomotic leakage developed in 18 (18.3%) patients. The average gestational age at birth was 35.4 weeks; the patients included ten girls and eight boys of average weight 2.41 kg; the average referral period was 2.1 days after birth and the average time of surgery was 2.4 days after birth. The average recovery time was 21.1 days (range: 8–60 days). Eight patients developed stenosis that recovered with dilatation.
CONCLUSION: Our findings suggest that our conservative treatment approach, which uses a nasojejunal catheter, is an effective method that would reduce complications, enable earlier feeding, and reduce the cost compared to other treatment approaches.

Çocuklarda özofagus atrezisi kaçaklarýna farklý bir yaklaþým

AMAÇ: Farklý bir konservatif yaklaþýmla özofagus kaçaðý nedeniyle tedavi edilen hastalarýn sonuçlarýný sunmayý amaçladýk.
GEREÇ VE YÖNTEM: Kliniðimizde Þubat 2013–Ocak 2018 tarihleri arasýnda trakeoözofageal fistüllü özofagus atrezisi (EA) nedeniyle ameliyat edilen olan 98 hasta geriye dönük olarak incelendi. Anastomoz kaçaðý olan hastalarda gebelik haftasý, cinsiyet, vücut aðýrlýðý, baþvuru günü, iyileþme süresi ve stenoz kaydedildi. Kaçak tespitinden sonra, nazogastrik kateter floroskopik olarak bir kýlavuz tel kullanýlarak nazojejunal katetere dönüþtürüldü ve beslenme devam etti.
BULGULAR: Anastomoz kaçaðý 18 (%18.3) hastada geliþti. Ortalama gebelik yaþý yaþý 35.4 haftaydý; hastalarýn onu kýz ve sekizi erkekti. Ortalama aðýrlýk 2.41 kg idi. Baþvuru günü doðumdan sonra ortalama 2.1 gün ve ortalama ameliyat zamaný doðumdan sonra 2.4 gün idi. Ortalama iyileþme süresi 21.1 gündü (8–60 gün). Sekiz hastada dilatasyon ile iyileþen darlýk geliþti.
TARTIÞMA: Nazojejunal kateter kullanýlarak yapýlan konservatif tedavi yaklaþýmýmýzýn diðer tedavi yaklaþýmlarýna kýyasla komplikasyonlarý azaltýp, erken beslenmeyi saðlayacak ve maliyeti düþürecek etkili bir yöntem olduðuna inanýyoruz.