Perioperative Outcomes in Neonates with Esophageal Atresia with or without Tracheoesophageal Fistula

Objective: To evaluate the perioperative outcomes in neonates undergoing surgical repair of esophageal atresia with or without tracheoesophageal fistula (EA/TEF) and to determine the associated factors contributing to prolonged postoperative hospital length of stay (LOS) and death. Material and Method: The medical records of neonates diagnosed with EA/TEF who underwent surgical repairs from January 2004 to December 2013 were retrospectively analyzed. Results: Forty-nine patients were enrolled. Esophageal stricture, anastomotic leakage, postoperative pneumonia and atelectasis were 25.0%, 6.3%, 27.1% and 6.3% respectively. Prematurity was the single significant risk factor for prolonged postoperative hospital LOS using a multiple logistic regression analysis (OR 5.55, 95% CI 1.11 to 27.73, p = 0.04). Low body weight (p = 0.03), cyanotic heart disease (OR 205.00, 95% CI 11.02 to 3,813.02, p<0.01) and pre-existing endotracheal tube (OR 14.09, 95% CI 1.48 to 134.30, p = 0.021) were potential risk factors for increasing mortality according to a univariate analysis. Consequently, there were 6 mortality cases (12.2%), mostly from pneumonia and sepsis. Conclusion: Postoperative esophageal stricture and pneumonia in neonates undergoing EA/TEF repair were common. Prematurity was a predictor for prolonged postoperative hospital LOS. Mortality rate increased in patients with low body weight, pre-existing endotracheal tube and cyanotic heart disease.