Efficacy of postoperative elective ventilatory support for leakage protection in primary anastomosis of congenital esophageal atresia

Keiichi Uchida, Mikihiro Inoue, Kohei Otake, Yoshiki Okita, Yuki Morimoto, Toshimitsu Araki, Chikao Miki, Masato Kusunoki

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)

Abstract

Anastomotic complications after primary repair of congenital esophageal atresia (EA) are recognized and feared complications. A close association exists between anastomotic leakage and the tension of the anastomosis on the suture line. This study aimed to evaluate the efficacy of postoperative elective ventilation support (PEVS) under paralysis with neck flexion after primary repair of EA. Forty-two EA patients; 4 cases with type A and 38 with type C by Gross classification received primary or delayed primary anastomosis between 1979 and 2003. PEVS has been introduced in the postoperative management of all EA cases since 1998. Vecuronium bromide was administered together with fentanyl citrate for five postoperative days. Patients were retrospectively divided into two groups: with or without PEVS management. There was no difference in operation data such as gastrostomy construction, gap between esophageal upper and lower pouch, primary or delayed primary anastomosis. PEVS under paralysis with neck flexion reduced postoperative anastomotic leakages in primary anastomosis with or without a Livaditis procedure. PEVS did not adversely increase anastomotic stricture, atelectasis, severe gastro-esophageal reflux, prolong days on ventilatory support or decrease survival rate. PEVS is an effective management method to decrease anastomotic complications for EA neonates.

Original languageEnglish
Pages (from-to)496-499
Number of pages4
JournalPediatric Surgery International
Volume22
Issue number6
DOIs
Publication statusPublished - 06-2006
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Surgery

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