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Am J Surg ; 213(4): 640-644, 2017 Apr.
Article in English | MEDLINE | ID: mdl-28057296

ABSTRACT

INTRODUCTION: Esophagrams are routinely performed following repair of esophageal atresia (EA) with or without tracheoesophageal fistula (TEF); however, its utility has not been validated. METHODS: EA/TEF repair performed from 2003 to 2014 at a single pediatric hospital and from 2004 to 2014 in the Pediatric Health Information System (PHIS) database were retrospectively reviewed to determine utility of esophagrams. RESULTS: Esophagram was performed in 99% of patients at our institution (N = 105). Clinical signs were seen prior to esophagram in patients whose leak changed clinical management. Esophagram on post-operative day ≤15 was performed in 66% of PHIS database patients (N = 3255). Esophagram did not change the incidence of chest tube placement, reoperation, or dilation. Patients who required a reoperation were less likely to have an esophagram than patients who did not require a reoperation (40.7% versus 65.7%, p < 0.001). CONCLUSION: Our data suggest that routine esophagram is not necessary in asymptomatic patients.


Subject(s)
Esophageal Atresia/surgery , Esophagus/diagnostic imaging , Postoperative Care , Tracheoesophageal Fistula/surgery , Anastomotic Leak/diagnostic imaging , Chest Tubes/statistics & numerical data , Dilatation/statistics & numerical data , Esophageal Stenosis/diagnosis , Female , Humans , Infant , Infant, Newborn , Male , Postoperative Complications/diagnostic imaging , Reoperation/statistics & numerical data , Retrospective Studies , Unnecessary Procedures
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