Esophageal Surveillance Practices in Esophageal Atresia Patients

Topic overview

Another article you should know by Cecilia Gigena

"Esophageal Surveillance Practices in Esophageal Atresia Patients: A Survey by the Eastern Pediatric Surgery Network" 

Authors: Malcolm N. Hamilton-Hall III, Dana Jungbauer, Christine Finck, William Middlesworth, Benjamin Zendejas, Samuel M. Alaish, Cornelia L. Griggs, Robert T. Russell, Hester F. Shieh, Stefan Scholz, Shaun M. Kunisaki, Christina Feng, Melissa E. Danko. Jennifer R. DeFazio. Charles J. Smithers. Irving J. Zamora. J. Leslie Knod, On behalf of theEastern Pediatric Surgery Network

Full article: https://www.jpedsurg.org/article/S0022-3468(23)00151-3/fulltext

Abstract

Introduction

Endoscopic surveillance guidelines for patients with repaired esophageal atresia (EA) rely primarily on expert opinion. Prior to embarking on a prospective EA surveillance registry, we sought to understand EA surveillance practices within the Eastern Pediatric Surgery Network (EPSN).

Methods

An anonymous, 23-question Qualtrics survey was emailed to 181 physicians (surgeons and gastroenterologists) at 19 member institutions. Likert scale questions gauged agreement with international EA surveillance guideline-derived statements. Multiple-choice questions assessed individual and institutional practices.

Results

The response rate was 77%. Most respondents (80%) strongly agree or agree that EA surveillance endoscopy should follow a set schedule, while only 36% claimed to perform routine upper GI endoscopy regardless of symptoms. Many institutions (77%) have an aerodigestive clinic, even if some lack a multi-disciplinary EA team. Most physicians (72%) expressed strong interest in helping develop evidence-based guidelines.

Conclusions

Our survey reveals physician agreement with current guidelines but weak adherence. Surveillance methods vary greatly, underscoring the lack of evidence-based data to guide EA care. Aerodigestive clinics may help implement surveillance schedules. Respondents support evidence-based protocols, which bodes well for care standardization. Results will inform the first multi-institutional EA databases in the United States (US), which will be essential for evidence-based care.

Level of Evidence

This is a prognosis study with level 4 evidence.

Intended audience: Healthcare professionals and clinicians.