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Increased Musculoskeletal Deformities And Decreased Lung Volume In Patients After Ea/Tef Repair - A Real-Time Mri Study.
Aubert, Ophelia; Lacher, Martin; Mayer, Steffi; Frahm, Jens; Voit, Dirk; Rosolowski, Maciej; Widenmann, Anke; Hirsch, Franz Wolfgang; Gräfe, Daniel.
Afiliação
  • Aubert O; Department of Pediatric Surgery, University Hospital Leipzig, Leipzig, Germany.
  • Lacher M; Department of Pediatric Surgery, University Hospital Leipzig, Leipzig, Germany.
  • Mayer S; Department of Pediatric Surgery, University Hospital Leipzig, Leipzig, Germany.
  • Frahm J; Biomedical NMR, Max Planck Institute for Multidisciplinary Sciences, Göttingen, Germany.
  • Voit D; Biomedical NMR, Max Planck Institute for Multidisciplinary Sciences, Göttingen, Germany.
  • Rosolowski M; Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany.
  • Widenmann A; Patient Organization for Esophageal Diseases KEKS e.V., Stuttgart, Germany.
  • Hirsch FW; Department of Pediatric Radiology, University Hospital Leipzig, Leipzig, Germany.
  • Gräfe D; Department of Pediatric Radiology, University Hospital Leipzig, Leipzig, Germany.
Ann Surg ; 2024 Feb 08.
Article em En | MEDLINE | ID: mdl-38328992
ABSTRACT

OBJECTIVE:

This study aims to assess morphological and functional postoperative changes after open or minimally invasive (MIS) repair of esophageal atresia (EA) compared to healthy controls by thoracic real-time MRI. SUMMARY BACKGROUND DATA Musculoskeletal deformities and pulmonary morbidity are common in children after EA repair. The real-time MRI is a novel technique that provides ultrafast, high-quality images during spontaneous breathing, without sedation even in young children.

METHODS:

Children aged 3-18 years were prospectively examined with a 3 Tesla MRI. Musculoskeletal deformities, static thoracic cross-sectional areas (CSA) at three different levels and lung volumes, as well as dynamic right-to-left ratio of CSA of hemithoraces and lung volumes during forced breathing were evaluated.

RESULTS:

72 children (42 open, 8 MIS, 22 controls) were recruited. In the EA group, rib fusions and adhesions (78%, P<0.01) and scoliosis (15%, P=0.32) were found after thoracotomy, but not after MIS. Mean right-to-left ratio of CSA and lung volumes were lower after EA repair compared to controls (P <0.05), indicating impaired thoracic and lung development. The number of thoracotomies was a significant risk factor for smaller thoracic volumes (P<0.05).

CONCLUSIONS:

For the first time, morphological changes and thoracic motility after EA repair were visualized by dynamic real-time MRI. Children after EA repair show decreased right-sided thoracic and lung development compared to controls. Open repair leads to significantly more musculoskeletal deformities. This study emphasizes that musculoskeletal morbidity following a thoracotomy in infancy is high.

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article