Lung function abdominalities follwing repaired esophageal atresia and tracheoesophageal fistula

ABSTRACT

Esophageal atresia and tracheo-esophageal fistula [EA/TEF] is common in the neonatal period and survival depends on the severity of the associated anomalies, prematurity and pre-morbid factors. This study represents the experience of a tertiary care center in Saudi Arabia of pulmonary function test abnormalities [PFT] after repair of [EA/TEF] including long-term effect on the lungs. A retrospective review of all patients referred to pulmonary clinic with EA/TEF and or Pre-operative evaluations from the period 1993-2004. A total of 41 patients. Twenty-six [63%] males and 15 [37%] females. EA/TEF was diagnosed at birth in 34 [83%]. EA and distal TEF were found in 37 [90%] of the patients. Congenital anomalies were associated in 28 [68%]. More than 1/3 of the patients had postoperative complications including pneumothorax, recurrent TEF, leakage at operation site and empyema. More than two-third of the patients required prolonged ventilation. Pulmonary complications developed in > 70% of the patients including persistent atelectasis, chronic aspiration pneumonia, tracheomalacia in 12 [29%] and bronchiectasis in 7 [17%]. Eighty-eight percent of patients who were able to do PFT showed abnormal values of moderate obstructive and restrictive lung disease. [EA/TEF] form significant PFT abnormalities and cause significant morbidities that may last for a long period of time