Mehran Peyvasteh, Shahnam Askarpour, Mohammad Hossein Sarmast Shoushtari.
A study of Esophageal strictures after surgical repair of Esophageal atresia.
Pak J Med Sci Jan ;22(3):269-72.

Objective: The aim of this study was to find out the prevalence of esophageal stricture (ES) following surgical repair of esophageal atresia. Patients and Methods: This retrospective study was carried out in two referral hospital (Bahrami & Children Medical Centre) from April 1999 till March 2000. Data was collected from patient`s file and follow up clinics. Seventy four patients with esophageal atresia were operated during this period. Twenty one patients who died and two patients with long gap esophageal atresia were excluded from the study. Hence fifty one patients were included in this study. End to end anastomosis was done in 45 and end to side anastomosis in 6 patients. Forty five patients had extrapleural thoracotomy while 6 patients had intrapleural thoracotomy. Single layer and double layer anastomosis were done in 36 and 25 patients respectively. Vicryl was used for repair in 47 babies and silk in 4 patients. Standard post operative care was provided to all patients. Results: Of 51 patients who survived 28 (54.8%) were male 23 (45.2%) female. Anastomotic leak was seen in 10 (19.6%) babies. 26 patients (M=16, F=10) developed ES. 22 (43.1%) patients had radiologically proven gastro-esophageal reflux. Incidence of stricture formation was significantly higher in babies who developed anastomosis leak after repair (p<0.05). Conclusions: GER and leakage from the anastomosis site were significantly higher in the group A. The risk of stricture formation is a potential threat for up to a year in patients without G.E.R and up to 18 months in patients with GE Reflux. Leakage of anastomosis and GE Reflux play a major role in post operative strictures after esophageal atresia repair so treatment and prevention of these complications are very important.

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