A comparison of surgical outcomes between in-hours and after-hours tracheoesophageal fistula repairs

Journal of Pediatric Surgery
Anthony Yeung, Sonia A Butterworth

Abstract

Emerging literature has found increased complications for some patients undergoing nonemergent surgeries performed after-hours. For infants born with esophageal atresia and tracheoesophageal fistula (EA/TEF), no literature exists addressing the impact of the timing of surgery on outcomes. With IRB approval, EA/TEF repairs (2005-2010) performed at a tertiary children's hospital were reviewed retrospectively. All patients had an esophageal anastomosis. After-hours surgeries were defined as 1530-0800 Monday to Friday, weekends/holidays. Demographics, EA/TEF type, operative details, anastomotic tension, and complications were compared. Outcomes measured included intraoperative desaturations, esophageal complications (leak, stricture, recurrence), pneumothorax, and mortality. There were 28 patients, of which 21 underwent the procedure in-hours and 7 after-hours. Patient age, gestational age, weight, EA/TEF type, cardiac anomalies, and preoperative, intraoperative, and postoperative variables were not different between the groups. Operative time, intraoperative desaturations, anastomotic tension, blood loss, total ventilation days, or length of hospitalization were not significantly different. There was a significant increase in esop...Continue Reading

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Citations

Mar 5, 2016·Journal of Pediatric Surgery·Arash J SayariJuan E Sola
Mar 8, 2016·Journal of Pediatric Surgery·Grace Chan, Sonia A Butterworth
Dec 4, 2015·ANZ Journal of Surgery·Grant IsedaleMark Rider
May 25, 2016·Paediatric Respiratory Reviews·Warwick J Teague, Jonathan Karpelowsky
May 26, 2016·Pediatric Surgery International·Katherine W GonzalezCharles L Snyder
Mar 17, 2018·Archives of Disease in Childhood·Louise RamsdenSimon J Clark
Apr 20, 2019·Nature Reviews. Disease Primers·Marinde van LennepMichiel P van Wijk
Dec 14, 2018·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Raphaële Charest-MorinJohn Street

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