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Eur J Pediatr Surg 2022; 32(04): 334-345
DOI: 10.1055/s-0041-1731391
Original Article

Long-Term Outcomes and Health-Related Quality of Life in a Swiss Patient Group with Esophageal Atresia

Anthony di Natale 
1   Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland
,
Jessica Brestel
1   Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland
,
Andrea Alexis Mauracher 
2   Division of Immunology, University Children's Hospital Zurich, Zurich, Switzerland
,
Sasha Job Tharakan 
1   Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland
,
Martin Meuli 
1   Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland
,
Ueli Möhrlen 
1   Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland
,
Ulrike Subotic 
1   Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland
› Author Affiliations Funding None.
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Abstract

Introduction Surgical treatment of esophageal atresia (EA) has markedly improved, allowing the focus to shift from short-term complications and mortality to long-term complications and quality of life. Health-related quality of life (HRQoL) is variable and reported to range from reduced to unimpaired in patients with repaired EA. We assessed the HRQoL, determined the prevalence of long-term complications and their possible impact on the HRQoL in patients who had correction of EA in Switzerland. Further, we also investigated in the general well-being of their parents.

Materials and Methods Patients with EA repair in Switzerland between 1985 and 2011 were enrolled. Long-term complications were assessed by enquiring disease-related symptoms, standardized clinical examinations, and analysis of radiographs. HRQoL was inquired using different validated questionnaires (KIDSCREEN-27, World Health Organization [WHO]-5, and Gastrointestinal Quality of Life Index [GIQLI]). Patients were grouped according to their age. In underage patients, general well-being of the parents was assessed using the WHO-5 questionnaire.

Results Thirty patients were included with a mean age of 11.3 ± 5.7 years. Long-term complications were present in 63% of all patients. HRQoL in underage patients was comparable to the provided reference values and rated as good, while adult patients reported a reduced HRQoL. The presence of gastroesophageal reflux disease symptoms was associated with reduced HRQoL in underage patients. Parents of underage patients stated a good general well-being.

Conclusion Long-term complications among patients with repair of EA in Switzerland are common. HRQoL in underage patients is good and general well-being of their parents is unimpaired. Adult patients reported a reduced HRQoL, consistent with other reports. As long-term complications may manifest only later in life, a structured follow-up of patients with an EA repair during childhood and adolescence is needed.

Keywords

esophageal atresia - health-related quality of life - long-term follow-up

Informed Consent

The authors hereby confirm that informed consent was obtained from all individual patients included in this study.


Authors' Contribution

A. di Natale: Study design and conception, performed physical examinations and acquisition of data, wrote and edited the manuscript. J. Brestel: Acquisition of data. A.A. Mauracher: Substantial contribution in statistical analysis and interpretation of data, critical revision. S.J. Tharakan: Substantial contribution in interpretation of data, critical revision, and final approval of the version to be published. M. Meuli: Critical revision and final approval of the version to be published. U. Moehrlen: Substantial contribution in interpretation of data, critical revision, and final approval of the version to be published. U. Subotic: Designed study protocol, substantial contribution in interpretation of data, and final approval of the version to be published.


Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and cantonal research committee (The local Ethics Committee of Zurich, BASEC Nr. PB_2016-00301) and with the Declaration of Helsinki 1964 and its later amendments or comparable ethical standards.


Supplementary Material



Publication History

Received: 14 February 2021

Accepted: 17 May 2021

Article published online:
29 July 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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