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Öztorun Cİ, Ulukaya Durakbaşa Ç, Soyer T, Özcan C, Fırıncı B, Demirel BD, Çiftçi İ, Parlak A, Öztan MO, Göllü Bahadır G, Akkoyun İ, Karaman A, Gül C, Şalcı G, İlhan H, Oral A, Özcan R, Özaydın S, Kılıç ŞS, Kıyan G, Erdem AO, Uzunlu O, Yıldız A, Özçakır E, Ertürk N, Erginel B, Öztaş T, Atıcı A, Mert M, Samsum H, Özen MA, Aydın E, Sancar S. Determining the Risk Factors for Anastomotic Stricture Development after Esophageal Atresia Repair: Results from the Turkish Esophageal Atresia Registry. Eur J Pediatr Surg 2024. [PMID: 38848757 DOI: 10.1055/a-2340-9078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
INTRODUCTION Anastomotic stricture (AS) is the second most common complication after esophageal atresia (EA) repair. We aimed to evaluate the data in the Turkish Esophageal Atresia Registry to determine the risk factors for AS development after EA repair in a large national cohort of patients. METHODS The data between 2015 and 2021 were evaluated. Patients were enrolled into two groups according to the occurrence of AS. Patients with AS (AS group) and without AS (non-AS group) were compared according to demographic and operative features, postoperative intubation status, and postoperative complications, such as anastomotic leaks, fistula recanalization, and the presence of gastroesophageal reflux (GER). A multivariable logistic regression analysis was performed to define the risk factors for the development of AS after EA repair. RESULTS Among the 713 cases, 144 patients (20.19%) were enrolled into the AS group and 569 (79.81%) in the non-AS group. The multivariable logistic regression showed that, being a term baby (odds ratio [OR]: 1.706; p = 0.006), having a birth weight over 2,500 g (OR: 1.72; p = 0.006), presence of GER (OR: 5.267; p < 0.001), or having a recurrent tracheoesophageal fistula (TEF, OR: 4.363; p = 0.006) were the risk factors for the development of AS. CONCLUSIONS The results of our national registry demonstrate that 20% of EA patients developed AS within their first year of life. In patients with early primary anastomosis, birth weight greater than 2,500 g and presence of GER were risk factors for developing AS. When patients with delayed anastomosis were included, in addition to the previous risk factors, being a term baby, and having recurrent TEF also became risk factors. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Can İhsan Öztorun
- Department of Pediatric Surgery, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Çiğdem Ulukaya Durakbaşa
- Department of Pediatric Surgery, Faculty of Medicine, Istanbul Medeniyet University, İstanbul, Turkey
| | - Tutku Soyer
- Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Coşkun Özcan
- Department of Pediatric Surgery, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Binali Fırıncı
- Department of Pediatric Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Berat Dilek Demirel
- Department of Pediatric Surgery, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - İlhan Çiftçi
- Department of Pediatric Surgery, Faculty of Medicine, Selçuk University, Konya, Turkey
| | - Ayşe Parlak
- Department of Pediatric Surgery, Faculty of Medicine, Uludağ University, Bursa, Turkey
| | - Mustafa Onur Öztan
- Department of Pediatric Surgery, Faculty of Medicine, Izmir Katip Celebi University, İzmir, Turkey
| | - Gülnur Göllü Bahadır
- Department of Pediatric Surgery, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - İbrahim Akkoyun
- Department of Pediatric Surgery, Konya Education and Research Hospital, Konya, Turkey
| | - Ayşe Karaman
- Department of Pediatric Surgery, University of Health Sciences Turkey, Ankara Dr Sami Ulus Children's Hospital, Ankara, Turkey
| | - Cengiz Gül
- Department of Pediatric Surgery, University of Health Sciences Turkey, Zeynep Kamil Maternity and Children Health and Research Application Center, İstanbul, Turkey
| | - Gül Şalcı
- Department of Pediatric Surgery, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Hüseyin İlhan
- Department of Pediatric Surgery, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir Turkey
| | - Akgün Oral
- Department of Pediatric Surgery, Dr. Behcet Uz Education and Research Hospital, Izmir, Turkey
| | - Rahşan Özcan
- Department of Pediatric Surgery, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Seyithan Özaydın
- Department of Pediatric Surgery, University of Health Sciences Turkey, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Şeref Selçuk Kılıç
- Department of Pediatric Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Gürsu Kıyan
- Department of Pediatric Surgery, Faculty of Medicine, Maramara University, Istanbul, Turkey
| | - Ali Onur Erdem
- Department of Pediatric Surgery, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey
| | - Osman Uzunlu
- Department of Pediatric Surgery, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Abdullah Yıldız
- Department of Pediatric Surgery, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Esra Özçakır
- University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Nazile Ertürk
- Department of Pediatric Surgery, Faculty of Medicine, Muğla Sıtkı Kocaman University, Muğla, Turkey
| | - Başak Erginel
- Department of Pediatric Surgery, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tülin Öztaş
- University of Health Sciences, Diyarbakır Training and Research Hospital, Diyarbakır, Turkey
| | - Ahmet Atıcı
- Department of Pediatric Surgery, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey
| | - Mehmet Mert
- Department of Pediatric Surgery, University of Health Sciences Van Training and Research Hospital, Van, Turkey
| | - Hakan Samsum
- Department of Pediatric Surgery, Private Antakya Academy Hospital, Hatay, Turkey
| | - Mehmet Ali Özen
- Department of Pediatric Surgery, School of Medicine, Koç University, Istanbul, Turkey
| | - Emrah Aydın
- Department of Pediatric Surgery, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
| | - Serpil Sancar
- Department of Pediatric Surgery, Bursa City Hospital, Bursa, Turkey
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Madadi-Sanjani O, Ure BM. Benchmarks for Pediatric Surgical Registries: Recommendations for the Assessment and Grading of Complications. Eur J Pediatr Surg 2024; 34:182-188. [PMID: 37871645 DOI: 10.1055/a-2196-1755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Procedure-related registries in general surgical practice offer a platform for prospective trials, the pooling of data, and detailed outcome analysis. Recommendations by the Idea, Development, Exploration, Assessment, and Long-term follow-up (IDEAL) collaboration and Outcome4Medicine have further improved the uniform reporting of complications and adverse events.In the pediatric surgical network, disease-specific registries for rare and inherited congenital anomalies are gaining importance, fostering international collaborations on studies of low-incidence diseases. However, to date, reporting of complications in the pediatric surgical registries has been inconsistent. Therefore, the European Reference Network for Rare Inherited and Congenital Anomalies (ERNICA) recently endorsed the validation of the first severity grading system for children. The planned reform of the European Paediatric Surgical Audit (EPSA) registry, which includes the implementation of the Clavien-Madadi classification, represents a further effort to establish uniform outcome reporting.This article provides an overview of experiences with surgical registries and complication reporting, along with the potential application of this knowledge to future pediatric surgical practice.
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Affiliation(s)
| | - Benno M Ure
- Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany
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Sfeir R, Aumar M, Sharma D, Labreuche J, Dauchet L, Gottrand F. The French Experience with a Population-Based Esophageal Atresia Registry (RENATO). Eur J Pediatr Surg 2024; 34:137-142. [PMID: 37940126 DOI: 10.1055/a-2206-6837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
This paper presented a national register for esophageal atresia (EA) started in January 2008. We report our experience about the conception of this database and its coordination. Data management and data quality are also detailed. In 2023, more than 2,500 patients with EA are included. Prevalence of EA in France was calculated at 1.8/10,000 live birth. Main clinical results are listed with scientific publications issued directly from the register.
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Affiliation(s)
- Rony Sfeir
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Reference Center for Congenital and Malformative Esophageal Disorders, Jeanne de Flandre Children's Hospital, Lille University Faculty of Medicine, Lille Cedex, Lille, France
| | - Madeleine Aumar
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Reference Center for Congenital and Malformative Esophageal Disorders, Jeanne de Flandre Children's Hospital, Lille University Faculty of Medicine, Lille Cedex, Lille, France
| | - Dyuti Sharma
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Reference Center for Congenital and Malformative Esophageal Disorders, Jeanne de Flandre Children's Hospital, Lille University Faculty of Medicine, Lille Cedex, Lille, France
| | - Julien Labreuche
- SEED: Statistique, Evaluation, Economique, Data-Management Maison Régionale de la Recherche Clinique University Hospital of Lille, France - Health Statistics, Lille, France
| | - Luc Dauchet
- Department of Epidemiology and Public Health, University Hospital of Lille, France - Public Health, Lille, France
| | - Frederic Gottrand
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Reference Center for Congenital and Malformative Esophageal Disorders, Jeanne de Flandre Children's Hospital, Lille University Faculty of Medicine, Lille Cedex, Lille, France
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