This study reports the influence of birth weight on surgical outcome(s) of newborns with oesophageal atresia.
Newborns undergoing repair of oesophageal atresia at a single centre during 1999 - 2016 were classified in three patient groups - ( i ) Group A - VLBW < 1.5kg ( ii ) Group B LBW < 2.5kg and ( iii ) Birth weight (BWT) > 2.5kg. Outcome data analyzed were – ( a ) success (%) of primary anastomosis at 1st operation ( b ) anastomotic leak(s) ( c ) stricture rate ( %) ( d ) requirement for other procedures - Nissen fundoplication, aortopexy, tracheostomy ( e ) oesophageal replacement and (e ) mortality. Fisher’s exact test was utilized for statistical testing.
138 newborns with oesophageal atresia were studied - Group A (N = 10), Group B (N = 48), Group C (N = 80). Inability to achieve a primary anastomosis was significantly higher in Group A (50%) vs Group B (8.3%), (p = 0.005) vs Group C (11%) (p = 0.007). No significant difference(s) were observed with Groups A, B and C comparing (i) anastomotic leak rate(s), (ii) stricture(s), (iii) oesophageal replacement rate(s) and the requirement for other procedures including (iv) mortality.
This study shows that VLBW babies born with oesophageal atresia are less likely to achieve successful primary anastomosis as newborns. Clinical outcome(s) after definitive restorative surgery with regard anastomotic leak, stricture rate(s), need for additional operation(s) and mortality is however comparable in VLBW, LBW and those babies with BWT > 2.5 kg.