Surgical treatment and major complications within the first year of life in newborns with long-gap esophageal atresia gross type A and B – a systematic review
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In brief
In brief
Systematic review of 326 newborns with long-gap esophageal atresia (Gross A/B) comparing surgical reconstruction methods and first-year complications. Delayed primary anastomosis was most common (68%) but showed higher rates of stricture (62%) and reflux (41%) versus alternative techniques like gastric pull-up.
Written by the GCMD Library team from the article.
Background
The surgical repair of long-gap esophageal atresia (LGEA) is still a challenge and there is no consensus on the preferred method of reconstruction. We performed a systematic review of the surgical treatment of LGEA Gross type A and B with the primary aim to compare the postoperative complications related to the different methods within the first postoperative year.
Methods
Systematic literature review on the surgical repair of LGEA Gross type A and B within the first year of life published from January 01, 1996 to November 01, 2016.
Results
We included 57 articles involving a total of 326 patients of whom 289 had a Gross type A LGEA. Delayed primary anastomosis (DPA) was the most applied surgical method (68.4%) in both types, followed by gastric pull-up (GPU) (8.3%). Anastomotic stricture (53.7%), gastro-esophageal reflux (GER) (32.2%) and anastomotic leakage (22.7%) were the most common postoperative complications, with stricture and GER occurring more often after DPA (61.9% and 40.8% respectively) compared to other methods (p