Hannon, E;
Eaton, S;
Curry, J;
Kiely, E;
Spitz, L;
De Coppi, P;
(2020)
Outcomes in adulthood of gastric transposition for complex and long gap oesophageal atresia.
Journal of Pediatric Surgery
, 55
(4)
pp. 639-645.
10.1016/j.jpedsurg.2019.08.012.
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Abstract
Background: Long term outcomes of gastric transposition (GT) for complex oesophageal atresia (OA) are poorly reported. We aimed to perform comprehensive long term follow up of adults who had been treated with GT for OA as children. / Methods: Consecutive patients who underwent GT for OA in childhood aged > 18 years old were identified alongside age matched patients who had primary repair (PR). Type of OA, co-morbidities and details of surgery were recorded. Telephone interviews included medical history, current symptoms - including gastro intestinal symptom rating scale (GSRS), morbidity and health related quality of life (HRQoL) using gastro-intestinal quality of life index (GIQLI). / Results: 32 participants were interviewed in each group (mean age 29 years). BMI (19.9 ± 3.5) was significantly lower (p = 0.0006) in GT group. 6/32 (19%) still required supplementary feeding. Adult morbidity included anastomotic stricture (34%), chronic respiratory disease (28%), dumping symptoms (25%), anemia (47%) and depression (19%). 3 patients required major revision surgery. Participants in both groups report regular upper gastrointestinal symptoms (GSRS: GT = 2.1, PR = 2.0) and were more symptomatic than the normal population (1.4) but not statistically different from each other. HRQoL (GIQLI = 113) was lower than after PR (122) but not significantly different (p = 0.29) and the normal population (125). 23% of GT participants had higher than normal HRQoL. / Conclusions: GT for OA is associated with significant morbidity and symptoms, including issues previously unreported in adulthood such as mental health problems. This mandates long term follow up and quality transition of these patients into adult care.
| Type: | Article |
|---|---|
| Title: | Outcomes in adulthood of gastric transposition for complex and long gap oesophageal atresia |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jpedsurg.2019.08.012 |
| Publisher version: | https://doi.org/10.1016/j.jpedsurg.2019.08.012 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Gastric transposition, Oesophageal atresia, Long term, Outcomes |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10080921 |
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