RESUMO
The treatment of esophageal atresia is not centralized in Germany. Therefore, high numbers of departments are involved. Data on the results of esophageal atresia repair from Germany are lacking. The aim of this study was to evaluate the early postoperative results after repair of esophageal atresia based on unbiased data of a German health insurance. We aimed to determine whether characteristics of the departments had an impact on outcome and compared the results from this study with the literature data from centers with a high caseload. Data of a German health insurance covering â¼10% of the population were analyzed. All patients who had undergone esophageal atresia repair from January 2007 to August 2012 were included. Follow-up data of 1 year postoperatively were analyzed. The potential impact of various characteristics of the treating surgical institutions was assessed. Results were compared with the latest international literature. Seventy-five patients with esophageal atresia underwent reconstructive surgery in 37 departments. The incidences of anastomotic leak (3%) and recurrent tracheoesophageal fistula (7%) were comparable with the literature (both 2-8%). Anastomotic stricture required dilatation in 57% of patients (mean 5.1 ± 5.6 dilatations) comparing unfavorably to most, but not all international reports. During 1-year follow-up, 93% of the patients were readmitted at least once (mean 3.9 ± 3.1 admissions). The incidence of complications did not correlate with any of the characteristics of the treating institutions such as academic affiliation, the number of consultants, beds, and preterm infants treated per year (all P > 0.05). Based on unbiased data, postoperative results after repair of esophageal atresia in Germany are comparable with recently published reports from international single centers. A correlation between the complication rate and characteristics of the treating institutions was not identified.
Assuntos
Anastomose Cirúrgica/efeitos adversos , Atresia Esofágica/cirurgia , Esofagoplastia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Anastomose Cirúrgica/métodos , Fístula Anastomótica/epidemiologia , Fístula Anastomótica/etiologia , Pré-Escolar , Bases de Dados Factuais , Estenose Esofágica/epidemiologia , Estenose Esofágica/etiologia , Estenose Esofágica/cirurgia , Esofagoplastia/métodos , Esôfago/cirurgia , Feminino , Seguimentos , Alemanha/epidemiologia , Humanos , Incidência , Lactente , Recém-Nascido , Seguro Saúde/estatística & dados numéricos , Masculino , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Fístula Traqueoesofágica/epidemiologia , Fístula Traqueoesofágica/etiologiaRESUMO
The article presents the interview results of 55 patients after esophagoplasty (30 cases - after esophagogastroplasty, 25 cases - after esophagoplasty) using questionnaire GIQLI. The authors came to conclusions about advantages of extirpation of esophagus with esopagogastroplasty compared with subtotal shunt esophagocoloplasty because of high rate of gastrointestinal index of the quality of life and their components in patients after esophagogastroplasty compared with results of patients after esophagoplasty. There was noted an expessed growth in the scales and rise of gastrointestinal index in patients who underwent esophagogastroplasty after 3 years of follow-up.
Assuntos
Estenose Esofágica/cirurgia , Esofagoplastia , Esôfago/cirurgia , Trato Gastrointestinal/fisiopatologia , Gastroplastia , Complicações Pós-Operatórias/psicologia , Qualidade de Vida , Adulto , Estenose Esofágica/epidemiologia , Estenose Esofágica/etiologia , Esofagoplastia/efeitos adversos , Esofagoplastia/métodos , Feminino , Seguimentos , Gastroplastia/efeitos adversos , Gastroplastia/métodos , Humanos , Efeitos Adversos de Longa Duração , Masculino , Medidas de Resultados Relatados pelo Paciente , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/fisiopatologia , Sibéria/epidemiologiaRESUMO
Com o objetivo de analisar eventuais diferenças entre os pacientes com e sem esofagite no coto esofágico, o autor estudou a evolução clínica e endoscópica em vinte e oito pacientes portadores de megaesôfago chagásico avançado após o tratamento cirúrgico pela esofagectomia subtotal associada à esofagogastroplastia com anastomose esofagogástrica cervical... (AU)