Respiratory morbidity in children who had undergone primary repair of esophageal atresia with tracheo esophageal fistula in a tertiary care centre in India

Authors

  • Madhan Kumar Department of Paediatrics, Christian Medical College, Vellore, Tamil Nadu, India
  • Sneha Deena Varkki Department of Paediatrics, Christian Medical College, Vellore, Tamil Nadu, India
  • Sampath Karl Department of Paediatrics, Christian Medical College, Vellore, Tamil Nadu, India
  • Harshjeet Singh Bal Department of Paediatrics, Christian Medical College, Vellore, Tamil Nadu, India
  • Aparna Irodi Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
  • Mary John Department of Paediatric ENT, Christian Medical College, Vellore, Tamil Nadu, India
  • Alok Rathi Department of Paediatric ENT, Christian Medical College, Vellore, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20211071

Keywords:

Oesophageal atresia/tracheo esophageal fistula, Respiratory morbidity and sequelae

Abstract

Background: Objective of the study was to assess the prevalence of respiratory and related GI morbidity in children who had undergone repair of oesophageal atresia/tracheoesophageal fistula (TEF) in the neonatal period.

Methods: Patients operated during the period 2008–2015 were evaluated in 2017 by clinical evaluation, radiological imaging (chest X-ray, barium swallow study and high-resolution computed tomographic scan) and laryngoscopy examination.

Results: Of the 50 neonates who underwent primary repair of TEF during the 8 year period, 39 were discharged successfully. Twenty-six of them at a Mean age of 64 months were included in the study. At the time of assessment, 65% of subjects registered body mass index (BMI) less than 10th centile. Abnormal respiratory system findings in 63% and digital clubbing in 27% were noted. Unilateral asymptomatic vocal cord was demonstrated in 7.7%. Radiological evaluation showed abnormal oesophageal motility/reflux in 54% and bronchiectasis in 19%. In addition, 62% had needed hospitalization for recurrent pneumonia in infancy. Environmental smoke exposure was reported in 38% and 73% had no regular follow up with a pediatrician.

Conclusions: This comprehensive evaluation of respiratory morbidity in children who had been operated for TEF in the neonatal period, demonstrated a high prevalence of reported respiratory morbidity in the first year of life. Poor nutritional outcomes and abnormal respiratory system examination were observed in a significant proportion. One-fifth of these patients had already developed bronchiectasis by a mean age of 75.4 months. Asymptomatic unilateral vocal cord palsy was another important finding.

Author Biography

Madhan Kumar, Department of Paediatrics, Christian Medical College, Vellore, Tamil Nadu, India

Child Health Unit III

References

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Published

2021-03-23

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Original Research Articles