The effect of azygos vein preservation on postoperative complications after esophageal atresia repair: Results from the Turkish Esophageal Atresia Registry.

Autor: Soyer T; Hacettepe University, Faculty of Medicine Department of Pediatric Surgery, Ankara, Turkey. Electronic address: soyer.tutku@gmail.com., Öztorun Cİ; Ankara Yildirim Beyazit University, Faculty of Medicine Department of Pediatric Surgery, Ankara, Turkey., Fırıncı B; Ataturk University, Faculty of Medicine Department of Pediatric Surgery, Erzurum Turkey., Durakbaşa ÇU; Istanbul Medeniyet University, Faculty of Medicine Department of Pediatric Surgery, Istanbul, Turkey., Bahadır GG; Ankara University, Faculty of Medicine Department of Pediatric Surgery, Ankara, Turkey., Karaman A; University of Health Sciences Turkey, Ankara Dr Sami Ulus Maternity and Children Health and Research Application Center, Department of Pediatric Surgery, Ankara, Turkey., Dökümcü Z; Ege University, Faculty of Medicine Department of Pediatric Surgery, Izmir Turkey., Akkoyun İ; Konya Education and Research Hospital, Department of Pediatric Surgery, Konya, Turkey., Demirel BD; Ondokuz Mayis University, Faculty of Medicine Department of Pediatric Surgery, Samsun, Turkey., Öztan MO; Izmir Katip Celebi University, Faculty of Medicine Department of Pediatric Surgery, Izmir, Turkey., Çiftçi İ; Selçuk University, Faculty of Medicine Department of Pediatric Surgery, Konya, Turkey., İlhan H; Eskişehir Osmangazi University, Faculty of Medicine Department of Pediatric Surgery, Eskişehir Turkey., Yalçın S; Karadeniz Technical University, Faculty of Medicine Department of Pediatric Surgery, Trabzon, Turkey., Özden Ö; Cukurova University, Faculty of Medicine Department of Pediatric Surgery, Adana, Turkey., Tekant GT; Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric Surgery, Istanbul, Turkey., Kıyan G; Maramara University, Faculty of Medicine Department of Pediatric Surgery, Istanbul, Turkey., Oral A; Dr. Behcet Uz Education and Research Hospital, Department of Pediatric Surgery, Izmir, Turkey., Güvenç Ü; Kanuni Sultan Suleyman Education and Research Hospital, Department of Pediatric Surgery, Istanbul, Turkey., Parlak A; Uludag University, Faculty of Medicine Department of Pediatric Surgery, Bursa, Turkey., Erginel B; Istanbul University, Faculty of Medicine Department of Pediatric Surgery, Istanbul, Turkey., Yıldız A; Sisli Hamidiye Etfal Education and Research Hospital, Department of Pediatric Surgery, Istanbul, Turkey., Erdem AO; Adnan Menderes University, Faculty of Medicine Department of Pediatric Surgery, Aydın, Turkey., Uzunlu O; Pamukkale University, Faculty of Medicine Department of Pediatric Surgery, Denizli, Turkey., Ertürk N; Muğla Sıtkı Kocaman University, Faculty of Medicine Department of Pediatric Surgery, Muğla, Turkey., Aydın E; Koç University, School of Medicine Department of Pediatric Surgery, Istanbul, Turkey., Samsum H; Private Antakya Academy Hospital, Department of Pediatric Surgery, Hatay, Turkey., Arslan UE; Hacettepe University, Institute of Public Health, Ankara, Turkey.
Jazyk: angličtina
Zdroj: Journal of pediatric surgery [J Pediatr Surg] 2021 Nov; Vol. 56 (11), pp. 1940-1943. Date of Electronic Publication: 2020 Dec 15.
DOI: 10.1016/j.jpedsurg.2020.12.008
Abstrakt: Aim: Preservation of the azygos vein (AV) maintains normal venous drainage of the mediastinum and decreases postoperative congestion. The modification of esophageal atresia (EA) repair by preserving AV may prevent postoperative complications and may lead to better outcomes. The data from the Turkish Esophageal Atresia Registry (TEAR) were evaluated to define the effect of AV preservation on postoperative complications of patients with EA.
Methods: Data from TEAR for a period of five years were evaluated. Patients were enrolled into two groups according to the preservation of AV. Patients with divided (DAV) and preserved AV (PAV) were evaluated for demographic and operative features and postoperative complications for the first year of life. The DAV and PAV groups were compared according to the postoperative complications, such as fistula recanalization, symptomatic strictures, anastomotic leaks, total number of esophageal dilatations, and anti-reflux surgery. In addition, respiratory problems, which required treatment, were compared between groups.
Results: Among 502 registered patients; the data from 315 patients with the information of AV ligation were included. The male female ratio of DAV (n = 271) and PAV (n = 44) groups were 150:121 and 21:23, respectively (p > 0.05). The mean body weight, height, gestational age, and associated anomalies were similar in both groups (p > 0.05). The esophageal repair with thoracotomy was significantly higher in DAV group, when compared to the PAV group (p < 0.05). The rates of primary anastomosis and tensioned anastomosis were similar in both groups (p > 0.05). There was no difference between DAV and PAV groups for anastomotic leaks, symptomatic anastomotic strictures, fistula recanalization, and the requirement for anti-reflux surgery (p > 0.05). The rate of respiratory problems, which required treatment, was significantly higher in the DAV group (p < 0.05) CONCLUSION: The data in the TEAR demonstrated that preserving the AV during EA repair led to no significant advantage on postoperative complications, with exception of respiratory problems. AV should be preserved as much as possible to maintain a normal mediastinal anatomy and to avoid respiratory complications.
(Copyright © 2020. Published by Elsevier Inc.)
Databáze: MEDLINE
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