Predictors of the Performance of Early Antireflux Surgery in Esophageal Atresia

Guillaume Podevin (1) , Françoise Schmitt (1) , Corinne Borderon , Olivier Jaby , Cecile Pelatan , Philine de Vries (2) , Myriam Pouzac-Arnould , Celine Grosos , Jean Breaud (3) , Christophe Laplace , Cecilia Tolg , Anicet Sika , Frederic Auber , Julien Labreuche (4) , Alain Duhamel (4) , Frederic Gottrand (5) , Berengere François (6) , Laurent Michaud (6) , Rony Sfeir (6) , Arnaud Bonnard (7) , Veronique Rousseau (8) , Sebastien Blanc , Thomas Gelas , Julia Boubnova (9) , Catherine Jacquier , Sabine Irtan (10) , Anne Breton , Virginie Fouquet , Audrey Guinot , Thierry Lamireau (11, 12) , Edouard Habounimana , Anne Schneider (13) , Frederic Elbaz , Aline Ranke , Marie-Laurence Poli-Merol (14) , Nicolas Kalfa (15) , Claire Dupont-Lucas , Thierry Petit , Jean-Luc Michel (16) , Philippe Buisson , Josephine Lirussi-Borgnon , Emmanuel Sapin (16) , Hubert Lardy , Guillaume Levard , Benoit Parmentier (17) , Clara Cremillieux , Manuel Lopez

1 CHU Angers - Centre Hospitalier Universitaire d'Angers
2 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
3 CHU Nice - Centre Hospitalier Universitaire de Nice
4 METRICS - Evaluation des technologies de santé et des pratiques médicales - ULR 2694
5 LIRIC - Lille Inflammation Research International Center - U 995
6 IRCAN - Institut de Recherche sur le Cancer et le Vieillissement
7 AP-HP Hôpital universitaire Robert-Debré [Paris]
8 INEM - UM 111 (UMR 8253 / U1151) - Institut Necker Enfants-Malades
9 Chirurgie orthopédique et pédiatrique [Hôpital de la Timone - APHM]
10 Service de neurochirurgie pédiatrique [CHU Necker]
11 CHU Bordeaux
12 BPH - Bordeaux population health
13 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
14 Hôpital universitaire Robert Debré [Reims]
15 Département Chirurgie Pédiatrique [CHRU Montpellier]
16 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
17 Service de gynécologie, obstétrique, médecine et biologie de la reproduction [CHU Poitiers] = Department of Gynecology, Obstetrics, Reproductive Medicine and Biology [Poitiers University Hospital]

Objective: To identify predictors of and factors associated with the performance of antireflux surgery during the first year of life in children born with esophageal atresia.Study design: All patients were included in a French registry for esophageal atresia. All 38 multidisciplinary French centers completed questionnaires about perinatal characteristics and one-year outcome for children born with esophageal atresia.Results: Of 835 infants with esophageal atresia born in France from 2010 to 2014, 682 patients, excluding those with long-gap esophageal atresia, were included. Three patients had type I, 669 had type III, and 10 had type IV esophageal atresia. Fifty-three children (7.8%) received fundoplication during the first year of life. The median age at the time of the end-to-end esophageal anastomosis was 1.1 day (range 0-15). Multivariate analysis identified three perioperative factors that predicted the need for early antireflux surgery: anastomotic tension (P = .004), associated malformations (P = .019), and low birth weight (P = .018). Six other factors, measured during the first year of life, were associated with the need for antireflux surgery: gastroesophageal reflux (P < .001), anastomotic stricture (P < .001), gastrostomy (P < .001), acute life-threatening event (P = .002), respiratory complications (P = .045), and poor nutritional status (P < .001).Conclusions: Gastroesophageal reflux disease, low birth weight, poor nutrition, and surgical anastomosis difficulties predicted the performance of antireflux surgery in the first year of life in infants with esophageal atresia.

Domaines: Sciences du Vivant [q-bio]

Guillaume Podevin, Françoise Schmitt, Corinne Borderon, Olivier Jaby, Cecile Pelatan, et al.. Predictors of the Performance of Early Antireflux Surgery in Esophageal Atresia. The Internet Journal of Pediatrics and Neonatology, 2019, 211, pp.120--125.e1. ⟨10.1016/j.jpeds.2019.03.045⟩. ⟨hal-02862216⟩