Liang Liang,Tan Zheng,Huang Ting,et al.Nutritional evaluation of postoperative anastomotic leakage in children with type Ⅲ esophageal atresia[J].Journal of Clinical Pediatric Surgery,,19():721-727.[doi:10.3969/j.issn.1671-6353.2020.08.012]
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Nutritional evaluation of postoperative anastomotic leakage in children with type Ⅲ esophageal atresia

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: 第19卷 Number: 2020 08 Page: 721-727 Column: 论著 Date of publication: 2020-08-20
Author(s):
Liang Liang1; 2;  Tan Zheng1; 2;  Huang Ting1; 2;  Long Qi2; 3;  Yu Jiangen1; 2
1. Departments of Thoracic Surgery;
2. National Clinical Research Center for Child Health;
3. Department of Clinical Nutrition;The Children’s Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
Keywords:
Esophageal Atresia/SU; Anastomotic Leakage; Postoperative Complications; Nutrition Assessment
CLC:
R722;R655.4;R151
DOI:
10.3969/j.issn.1671-6353.2020.08.012
Abstract:
Objective To explore the correlated factors and postoperative nutritional status with conservative treatment after surgical anastomotic leakage (AL) for type Ⅲ esophageal atresia. Methods From January 1, 2016 to January 31, 2020, clinical data were collected from 102 children with type Ⅲ esophageal atresia undergoing 1-stage tracheoesophageal fistula ligation and single-layer end-to-end esophageal anastomosis. They were divided into AL (n=26) and non-AL (n=76) groups according to the occurrence of postoperative complications. The correlated factors of AL were reviewed. Meanwhile, the outcome of conservative management for AL was evaluated. Results No significant differences existed in gestational age, gender, weight, comorbidity, procedure, prealbumin, weight-for-age (WAZ) or hypersensitive C-reactive protein (CRP)(P>0.05). A significant inter-group difference existed in preoperative albumin level (P=0.015). Type Ⅲa had a higher risk of AL than type Ⅲb (P=0.038). Multivariable logistic regression analysis demonstrated that long esophageal atresia (type Ⅲa) and low preoperative albumin level were the independent risk factors for AL. Twenty-two recovered after conservative measures and the average duration of recovery was (23.90±11.81) days. The preoperative albumin level and WAZ value of children with prolonged healing time were significantly lower than those with normal healing time (P=0.007 & P=0.019). No significant difference existed in serum prealbumin or WAZ value during perioperative period. Conclusion Preoperative nutritional status is one of risk factors of AL and affects self-healing time. AL in children with type Ⅲ esophageal atresia may recover after conservative measures. Effective total parenteral nutrition therapy maintains normal nutritional level during conservative management.

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Memo

收稿日期:2020-04-14。
基金项目:浙江省医药卫生一般研究计划（编号：2015KYB195）；浙江省科研基金项目（编号：2017KY435）
通讯作者:俞建根,Email:6192007@zju.edu.com

Last Update: 1900-01-01