Document Detail


Use of transanastomotic feeding tubes during esophageal atresia repair.
MedLine Citation:
PMID:  19433166     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Esophageal atresia (EA) with tracheoesophageal fistula (TEF) type C accounts for 85% of all EA. In our center, patients were previously started on total parenteral nutrition (TPN) postoperatively and oral feedings initiated only after a contrast esophagogram. Our aim is to assess the benefit of intraoperatively placed transanastomotic feeding tubes (TAFTs). METHODS: A 7-year retrospective review analyzed the outcomes of children with EATEF type C as they relate to the use of TAFT. Demographics, associated anomalies, operative findings, complications, duration of TPN, resumption of oral feeding, length of stay, and follow-up were examined. RESULTS: Twenty-one patients had EATEF type C. Eleven (55%) and 9 (45%) patients were identified as nonfeeding tube (NFT) and TAFT groups, respectively. There were no differences in gestational age, birth weight, associated anomalies, and interval to operative intervention or operative time. Excluding one patient with a severe cardiac malformation in the NFT group, there were no significant differences in anastomotic leak (8% vs 22%), stenosis (36% vs 22%), TPN duration (20 days vs 12 days), and cholestasis (36% vs 11%). CONCLUSION: Transanastomotic feeding tube may lead to shorter TPN duration and decreased cholestasis, but a larger prospective study would be required to prove these benefits and ensure that it does not increase anastomotic leaks. This could be done through an expanded Canadian Pediatric Surgery Network study.
Authors:
Saleh I Alabbad; Jon Ryckman; Pramod Shailendra Puligandla; Kenneth Shaw; Luong T Nguyen; Jean-Martin Laberge
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  44     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-12     Completed Date:  2009-10-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  902-5     Citation Subset:  IM    
Affiliation:
Division of Pediatric Surgery, The Montreal Children's Hospital, Montréal, Québec, Canada. saleh.al-abbad@mail.mcgill.ca
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MeSH Terms
Descriptor/Qualifier:
Anastomosis, Surgical
Cholestasis / prevention & control
Enteral Nutrition / instrumentation*
Esophageal Atresia / surgery*,  therapy
Esophageal Stenosis / etiology,  therapy
Female
Gastroesophageal Reflux / etiology,  prevention & control
Humans
Length of Stay / statistics & numerical data
Male
Parenteral Nutrition, Total
Pneumonia / etiology
Postoperative Complications / prevention & control
Respiration, Artificial / utilization
Retrospective Studies
Sepsis / etiology
Severity of Illness Index
Tracheoesophageal Fistula / surgery
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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