Endoscopic Surveillance After Repair of Oesophageal Atresia: Longitudinal Study in 209 Patients

Journal of Pediatric Gastroenterology and Nutrition
Antti KoivusaloRisto J Rintala

Abstract

After repair of oesophageal atresia (OA), the need for endoscopic follow-up (EFU) remains unclear. To end this, we assessed the trends of oesophageal mucosal changes in successive follow-up biopsies. EFU records of 264 patients including histological grades of oesophagitis (from 0 to III), gastric (GM) or intestinal (IM) metaplasia and dysplasia (mild to severe) at 1, 3, 5 10, 15, and >15 years after repair of OA were reviewed. Included were 209 patients with 616 biopsies. A total of 60 patients had undergone antireflux surgery and 24 had long-gap OA (LG). Median follow-up was 12 (range 1-17) years with 3 (1-6) endoscopies per patient. Highest grade of oesophagitis was Gr 0 (no oesophagitis) in 47%, Gr I in 37%, and Gr II or III in 16%. Metaplasia, GM (n = 31), IM (n = 4), occurred in 17% of patients and reached 15% prevalence by 15 years. Dysplasia and cancer were not found. From 1 to 15 years after repair grade of histological oesophagitis often fluctuated between Gr 0 and Gr I, but further progression was unlikely, hazard ratio = 0.2-3.4 (95% confidence interval 0.0-29), P = 0.06-0.87. LG and antireflux surgery predicted early detection of metaplasia (P < 0.001). Only 9% of patients with metaplasia and 32% with Gr II oesopha...Continue Reading

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Citations

Feb 2, 2017·Current Gastroenterology Reports·Arunjot SinghJulie Khlevner
Nov 28, 2017·Current Gastroenterology Reports·Hayat MousaChristophe Faure
Mar 29, 2019·Journal of Pediatric Gastroenterology and Nutrition·Jessica L YasudaMichael A Manfredi
Mar 2, 2017·Journal of Pediatric Gastroenterology and Nutrition·Helen HsiehChristophe Faure
Jun 23, 2018·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·A KoivusaloM Pakarinen
Apr 21, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Florian FriedmacherMichael E Höllwarth

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Methods Mentioned

BETA
biopsies
biopsy

Software Mentioned

StatView

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