Acid Suppression Duration does not Alter Anastomotic Stricture Rates after Esophageal Atresia with Distal Tracheoesophageal Fistula Repair: A Prospective Multi-Institutional Cohort Study
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In brief
In brief
Multi-institutional prospective study of 156 infants found that postoperative acid suppression therapy does not reduce anastomotic stricture rates after esophageal atresia repair, with 51% developing strictures regardless of treatment duration. Transanastomotic tube use was identified as a significant risk factor for stricture formation.
Written by the GCMD Library team from the article.
Introduction
Anastomotic stricture is the most common complication after esophageal atresia (EA) repair. We sought to determine if postoperative acid suppression is associated with reduced stricture formation.
Methods
A prospective, multi-institutional cohort study of infants undergoing primary EA repair from 2016 to 2020 was performed. Landmark analysis and multivariate Cox regression were used to explore if initial duration of acid suppression was associated with stricture formation at hospital discharge (DC), 3-, 6-, and 9-months postoperatively.
Results
Of 156 patients, 79 (51%) developed strictures and 60 (76%) strictures occurred within three months following repair. Acid suppression was used in 141 patients (90%). Landmark analysis showed acid suppression was not associated with reduction in initial stricture formation at DC, 3-, 6- and 9-months, respectively (p= 0.19-0.95). Multivariate regression demonstrated use of a transanastomotic tube was significantly associated with stricture formation at DC (Hazard Ratio (HR) = 2.21 (95% CI 1.24-3.95, p