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Experience of managing oesophageal atresia ± Tracheo-oesophageal fistula in a tertiary surgical neonatal centre in the UK
  1. S Ojha,
  2. L Elvidge,
  3. B Davies,
  4. A Deorukhkar
  1. Nottingham University Hospital, Nottingham, UK

Abstract

Introduction Oesophageal atresia/Tracheo-oesophageal fistula (OA±TOF) is estimated to occur in 1 in 2500–4000 live births.1 Prenatal diagnosis is possible by detecting polyhydraminos and absent stomach bubble on antenatal ultrasound. Some authors have reported no difference in outcome2 while others have shown that babies with prenatal diagnosis were more premature, had more associated anomalies and higher mortality.3

Method We reviewed the case notes of all OA±TOF babies in a single tertiary surgical neonatal intensive care unit (NICU), from January 2007 to September 2010.

Results 25 cases of OA±TOF were identified. 60% (15/25) were males, 76% (19/25) were low birth weight (LBW), 60% (15/25) were preterm. 20/25 (80%) had other associated anomalies. 11/25 (44%) babies had prenatal diagnosis (table 1). 17/25 (68%) were operated by day 2. Majority of babies needed <5 days of ventilation (80%). However NICU stay was often long. (Median 13 days, range 3–197). Two babies, both with lethal chromosomal anomalies died. The most common complication was gastro-oesophageal reflux (66.7%). There was no difference between those with prenatal and postnatal diagnoses.

View this table:
Abstract PC.01 Table 1

Comparison between cases with prenatal and postnatal diagnosis

Conclusion We concluded that most cases of OA±TOF are preterm and LBW. Most babies require long NICU stay but very short period of ventilation. There was no difference in the groups diagnosed prenatally versus those diagnosed post-natally, in this small sample. Death was only in those with other lethal anomalies.

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