Long-term Consequences of Anastomotic Leakage After Repair of Esophageal Atresia
Overview
This study evaluates the long-term impacts of anastomotic leakage following esophageal atresia (EA) repair, highlighting its association with increased esophageal morbidity and delayed feeding progression.
Background
Anastomotic leakage is a common complication after surgical repair of esophageal atresia, a congenital anomaly requiring neonatal intervention. Understanding the long-term consequences of this complication is crucial, as it can significantly affect feeding outcomes and overall quality of life in affected patients. This study aims to clarify the relationship between anastomotic leakage and subsequent esophageal complications.
Data Highlights
Outcome
Leakage Group
No Leakage Group
p-value
Anastomotic stricture
78%
57%
0.029
Time to feeding initiation
11 days
8 days
0.022
Time to oral feeding initiation
38 days
14 days
0.005
Time to full feeding
35 days
21 days
0.037
Time to oral full feeding
58 days
26 days
0.012
Unplanned reoperations
31%
11%
0.008
Key Findings
25.2% of patients developed anastomotic leakage post-EA repair.
Patients with leakage had a higher incidence of anastomotic stricture (78% vs. 57%, p = 0.029).
Delayed feeding progression was observed in the leakage group, with longer times to feeding initiation and oral feeding.
Unplanned reoperations were more frequent in patients with leakage (31% vs. 11%, p = 0.008).
Anastomotic leakage was associated with GERD, with an adjusted odds ratio of 2.60 (95% CI 1.14–6.26, p = 0.027).
Clinical Implications
Clinicians should be aware of the potential for delayed feeding progression and the development of GERD in these patients.
Conclusion
Anastomotic leakage after EA repair is linked to significant long-term complications, including esophageal morbidity and delayed feeding outcomes.
An ancillary analysis found less than 2-percentage-point differences in 10-year recurrence across margin thresholds, with no statistically significant adjusted association.
