Abstract
Aim of study: To evaluate nutritional status, feeding, gastrointestinal and respiratory problems and quality of life of children operated on for long - gap (LG) esophageal atresia (EA) and compare results of several surgical techniques. Methods: Children operated on for EA in 1992-2001 were included in the study.
Data about feeding problems, gastrointestinal and respiratory symptoms and quality of life were collected by a questionnaire filled in by parents of children with EA. Nutritional status evaluation was based on anthropometrical parameters: height, weight, head and arm circumference and skinfold thickness: triceps, subscapular, suprailiacal.
Children with LG were divided into subgroups according to surgical technique - primary anastomosis (PA), delayed anastomosis (DA) and esophageal substitution - gastric transposition (GT). Children without long - gap atresia with primary anastomosis served as a control group.
Results: 37.7% children after operation for EA have feeding difficulties, 26.1% have postprandial problems. Children with LG have higher incidence of nausea, dyspnoea, diarrhea.
The incidence of respiratory problems is 30.4%. Dyspnoea without and after exercise (25 and 28.6%, respectively) and during the night (23.8%) are more frequent after LG atresia.
This is also true for all subgroups of LG atresia - PA, DA, GT. The average height (-0.56 SD), weight (-0.82 SD), head (-0.51 SD) and arm circumference (-0.81 SD) are below the population average.
Children with DA have the worst results in the subgroups of LG: height -1.47 SD, weight -1.57 SD. Quality of life is considered to be good in 69.1%, favorable in 25%, unfavorable in 5.9%.
There are no statistically significant differences in quality of life evaluation in the subgroups. Conclusion: According to the results of long term follow up delayed anastomosis seems to be the least successful method in the treatment of long - gap esophageal atresia.