Is routine use of transanastomotic tube justified in the repair of esophageal atresia?

World J Pediatr. 2017 Dec;13(6):584-587. doi: 10.1007/s12519-017-0047-0. Epub 2017 Jun 27.

Abstract

Background: Transanastomotic feeding tube (TAFT) is commonly used for post-operative enteral nutrition after esophageal atresia (EA)/tracheoesophageal fistula (TEF) repairs. The purpose of this study is to analyze the therapeutic implications of avoiding a TAFT and its impact on the outcomes post-operatively.

Methods: The medical data of 33 inpatients with EA/TEF type C repair from 2009 to 2014 were retrospectively reviewed. Patients were divided into two groups for comparison based on the usage of TAFT during the repair: TAFT- (without) and TAFT+ (with) groups, without randomization. Both groups were compared statistically for post-operative complications and outcomes.

Results: Eighteen neonates were males and 15 females, with an average birth weight of 2.43±0.43 kg and a mean gestational age of 36.15 weeks. Nineteen (57.5%) in the TAFT- group and 14 (42.4%) were in the TAFT+ group. The post-operative complications, need for dilatations, duration of total parenteral nutrition (TPN) and length of hospital stay were similar in both groups. The incidence of pneumonitis was significantly higher in the TAFT+ group.

Conclusions: By avoiding a TAFT, there is no increase in complication rates nor does it entail a prolonged period of TPN. Besides, not using a TAFT may have the advantage of reducing incidence of aspiration and consequent pneumonitis.

Keywords: esophageal atresia; tracheo-esophageal fistula; transanastomotic tube.

Publication types

  • Comparative Study

MeSH terms

  • Cohort Studies
  • Disease-Free Survival
  • Enteral Nutrition / adverse effects*
  • Enteral Nutrition / methods
  • Esophageal Atresia / diagnosis
  • Esophageal Atresia / mortality
  • Esophageal Atresia / surgery*
  • Follow-Up Studies
  • Humans
  • India
  • Infant, Newborn
  • Male
  • Pneumonia, Aspiration / prevention & control*
  • Postoperative Care / methods
  • Retrospective Studies
  • Risk Assessment
  • Survival Rate
  • Tracheoesophageal Fistula / diagnosis
  • Tracheoesophageal Fistula / mortality
  • Tracheoesophageal Fistula / surgery*
  • Treatment Outcome