%0 Journal Article
%T Esophageal atresia with tracheoesophageal fistula and early postoperative mortality
%A Talal A Al-Malki
%A Ashraf H Ibrahim
%J West African Journal of Medicine
%D 2005
%I 
%X Background: Several recent reports showed that associated anomalies represent the main cause of postoperative mortality in infants born with esophageal atresia (EA) and/or tracheoesophageal fistula (TEF). Our observations present additional causes of mortality to the above mentioned. The aim of this study is to identify the major causes of early postoperative mortality in cases of EA and/or TEF in our setup. The ongoing preoperative classifications predicting mortality will be also used for comparison. Patients and methods: We reviewed 101 charts of all cases with EA and/or TEF in a period of 11 years from 1990 to 2000. Morbidity and causes of postoperative mortality during the first admissions were identified. The factors predicting mortality were documented. Patients were classified according to Waterston, Montreal and Spitz classifications. Results: Thirty-one patients (30.7%) died. Two main groups of post operative mortality were identified. The first group included the possibly avoidable causes of mortality which were primary sepsis (n=10, 32.3%), technical problems (n=8,25.8%) and severe pneumonia (n=5,16.1%). The unavoidable causes of mortality included major congenital anomalies (n=6, 19.3%) and anomalies incompatible with life (n=2, 6.5%). Conclusion: Primary sepsis and sepsis due to technical problems were the main causes of mortality in our series. Factors predicting mortality were pneumonia at presentation, sepsis at presentation or that acquired during hospitalization, major or life threatening anomalies, long gaps and major leaks. The Waterston classification was statistically the best applicable in this study. Key-words: Esophageal atresia, Tracheosopheal fistula, Mortality, Risk factors - congenital anomalies, Sepsis. R¨¦sum¨¦ Introduction: Des rapports diverses r¨¦cents avaient indiqu¨¦s que les anormalies li¨¦es repr¨¦sentent la cause principale de la mortalite postop¨¦ratoire chez des enfants n¨¦s atteints d'atresie oesophage (AO) et / ou fistule tracheoesophage (FTO) Nos observations donnent des causes supplementaires de la mortalit¨¦ en plus des causes cit¨¦es ci-dessus. L'objet de cette ¨¦tude est d'identifier les causes principales de la mortalite postop¨¦ratoire dans les cas de AO et / ou FTO dans notre programme. On va ¨¦galement utiliser cette classification pr¨¦op¨¦ratoire qui pr¨¦dit le taux de la mortalit¨¦ de faire la comparaison n¨¦cessaire. Patients et methods: Nous avons fait le bilan de 101 graphiques de tous les cas atteints de AO et / ou FTO d'une dur¨¦e de 11 ans de 1990 au 2000. Mobidit¨¦ et causes de la mortalit¨¦ postop¨¦ratoire pendant la premi¨¨re admission ont ¨¦t¨¦ identifi¨¦s. Des facteurs qui pr¨¦d¨¦terminent la mortalit¨¦ ont ¨¦t¨¦ document¨¦s. Les patients ont ¨¦t¨¦ group¨¦s selon les classification de Waterton, Montreal et Spitz. R¨¦sultat: Trente et un patients soit 30,7% ¨¦taient morts. On avait identifi¨¦ deux groupes majeurs de la mortalit¨¦ post op¨¦ratoire. Le premier groupe comprend les causes possible de la mortalit¨¦ ¨¦vitable qui
%U http://www.ajol.info/index.php/wajm/article/view/28223