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  1. Article ; Online: The long-term outcomes of symptomatic congenital lobar emphysema patients.

    Gatt, Dvir / Lapidus-Krol, Eveline / Chiu, Priscilla P L

    Pediatric pulmonology

    2023  Volume 58, Issue 5, Page(s) 1520–1526

    Abstract: Introduction: Surgical (OP) management for symptomatic congenital lobar emphysema (CLE) is the standard of care with nonoperative (NOP) approach applied for asymptomatic cases. The aim of this study is to report the outcomes for NOP approach to the care ...

    Abstract Introduction: Surgical (OP) management for symptomatic congenital lobar emphysema (CLE) is the standard of care with nonoperative (NOP) approach applied for asymptomatic cases. The aim of this study is to report the outcomes for NOP approach to the care of symptomatic CLE infants.
    Methods: A retrospective study of CLE patients treated 2000-2021 at a single institution. Patients with CLE and respiratory symptoms were included.
    Results: Overall, 23 children had symptomatic CLE, and 12 had NOP management. The median age at diagnosis was 38.5 days (50) in the NOP group versus 25 days (20) in the OP group (p = 0.31). There was no significant difference in the location of the involved lobe, term birth, postnatal diagnosis and gender, and both groups required noninvasive support in 33% of the cases. There was a trend towards higher frequency of oxygen support in the OP group preoperatively (89% vs. 42%, p = 0.07). The median length of stay was 14 days in the NOP group compared to a median postsurgery stay of 7.5 days in the OP group. In follow-up, there was no significant difference in respiratory readmission in first year of life, growth delay, treatment with asthma medication or body mass index in the NOP versus OP group. None of the children in the NOP group required surgery during follow-up.
    Conclusions: A NOP approach for symptomatic CLE infants can have favorable long-term outcomes. Further studies will be required to identify markers to aid in clinical decision-making.
    MeSH term(s) Infant ; Child ; Humans ; Retrospective Studies ; Pulmonary Emphysema/surgery ; Pulmonary Emphysema/diagnosis ; Tomography, X-Ray Computed ; Oxygen
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2023-03-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632784-9
    ISSN 1099-0496 ; 8755-6863
    ISSN (online) 1099-0496
    ISSN 8755-6863
    DOI 10.1002/ppul.26354
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    Zs.A 2143: Show issues Location:
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  2. Article ; Online: Unanticipated consequences of COVID-19 pandemic policies on pediatric acute appendicitis surgery.

    Quaglietta, Paula R / Ramjist, Joshua K / Antwi, Jeffrey / Kissoondoyal, Ashby / Lapidus-Krol, Eveline / Baertschiger, Reto M

    Journal of pediatric surgery

    2023  Volume 58, Issue 5, Page(s) 931–938

    Abstract: Background: Global pandemics may limit access to specialized care, delaying diagnosis and treatment of common acute surgical diseases. We analyzed the impact of the novel coronavirus disease 2019 (COVID-19) pandemic on acute appendicitis at an urban ... ...

    Abstract Background: Global pandemics may limit access to specialized care, delaying diagnosis and treatment of common acute surgical diseases. We analyzed the impact of the novel coronavirus disease 2019 (COVID-19) pandemic on acute appendicitis at an urban tertiary care center. We hypothesize that pandemics are associated with delayed presentation and worsened clinical sequelae, specifically, higher incidences of perforation in children.
    Methods: We retrospectively assessed patients admitted to our institution with acute appendicitis in pre-pandemic control (February 2018-June 2019) and COVID-19 (February 2020-June 2021) cohorts. Primary outcomes included complicated appendicitis rates (perforation/abscess/bowel obstruction), COVID-19 status, complications and travel distance to our institution. 1107 patients met inclusion criteria: 491 (44.4%) during the control period and 616 (55.6%) in the COVID-19 cohort. Statistical analysis involved t-tests, contingency tables and logistic regression modelling for key variables.
    Results: A larger proportion of complicated appendicitis occurred during COVID-19 compared to controls (28.3% vs 38.8%, p < 0.001). Symptom duration at presentation and length of stay were not significantly different. Duration of antibiotic treatment, surgery length, readmission rate and travel distances were significantly higher during COVID-19. The pre-pandemic cohort had a significantly younger age distribution.
    Conclusion: Pediatric appendicitis was significantly impacted during COVID-19, demonstrated by increased rates of complicated appendicitis, surgery duration and antibiotic duration. This may be an unintended secondary consequence of patients avoiding healthcare facilities for non-pandemic related illnesses or lockdown policies. Government policies directing all provincial pediatric appendicitis cases to pediatric institutions increased travel distances for our patients and had unanticipated consequences and resource requirements on tertiary healthcare.
    Level of evidence: Level III for "Treatment Studies".
    MeSH term(s) Humans ; Child ; Appendicitis/epidemiology ; Appendicitis/surgery ; COVID-19/epidemiology ; Communicable Disease Control ; Pandemics ; Retrospective Studies ; Acute Disease ; Anti-Bacterial Agents ; Policy ; Appendectomy
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2023-01-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80165-3
    ISSN 1531-5037 ; 0022-3468
    ISSN (online) 1531-5037
    ISSN 0022-3468
    DOI 10.1016/j.jpedsurg.2023.01.021
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    Zs.A 607: Show issues Location:
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  3. Article ; Online: Surgical management of acute life-threatening events affecting esophageal atresia and/or tracheoesophageal fistula patients.

    Fernandes, Rosephine Del / Lapidus-Krol, Eveline / Honjo, Osami / Propst, Evan J / Wolter, Nikolaus E / Campisi, Paolo / Chiu, Priscilla P L

    Journal of pediatric surgery

    2023  Volume 58, Issue 5, Page(s) 803–809

    Abstract: Background: Following surgical correction, many patients with esophageal atresia with or without tracheoesophageal fistula (EA/TEF) present to the emergency department (ED) with acute airway complications. We sought to determine the incidence and risk ... ...

    Abstract Background: Following surgical correction, many patients with esophageal atresia with or without tracheoesophageal fistula (EA/TEF) present to the emergency department (ED) with acute airway complications. We sought to determine the incidence and risk factors for severe acute life-threatening events (ALTEs) in pediatric patients with repaired congenital EA/TEF and the outcomes of operative interventions.
    Methods: A retrospective cohort chart review was performed on patients with EA/TEF with surgical repair and follow-up at a single centre from 2000 to 2018. Primary outcomes included 5-year ED visits and/or hospitalizations for ALTEs. Demographic, operative, and outcome data were collected. Chi-square tests and univariate analyses were performed.
    Results: In total, 266 EA/TEF patients met inclusion criteria. Of these, 59 (22.2%) had experienced ALTEs. Patients with low birth weight, low gestational age, documented tracheomalacia, and clinically significant esophageal strictures were more likely to experience ALTEs (p < 0.05). ALTEs occurred prior to 1 year of age in 76.3% (45/59) of patients with a median age at presentation of 8 months (range 0-51 months). Recurrence of ALTEs after esophageal dilatation was 45.5% (10/22), mostly due to stricture recurrence. Patients experiencing ALTEs received anti-reflux procedures (8/59, 13.6%), airway pexy procedures (7/59, 11.9%), or both (5/59, 8.5%) within a median age of 6 months of life. The resolution and recurrence of ALTEs after operative interventions are described.
    Conclusion: Significant respiratory morbidity is common among patients with EA/TEF. Understanding the multifactorial etiology and operative management of ALTEs have an important role in their resolution.
    Type of study: Original Research, Clinical Research.
    Level of evidence: Level III Retrospective Comparative Study.
    MeSH term(s) Humans ; Child ; Infant, Newborn ; Infant ; Child, Preschool ; Tracheoesophageal Fistula/epidemiology ; Tracheoesophageal Fistula/surgery ; Tracheoesophageal Fistula/complications ; Esophageal Atresia/surgery ; Esophageal Atresia/complications ; Retrospective Studies ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/surgery
    Language English
    Publishing date 2023-01-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80165-3
    ISSN 1531-5037 ; 0022-3468
    ISSN (online) 1531-5037
    ISSN 0022-3468
    DOI 10.1016/j.jpedsurg.2023.01.032
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    Zs.A 607: Show issues Location:
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  4. Article ; Online: I-PASS enhances effectiveness and accuracy of hand-off for pediatric general surgery patients.

    Wolinska, Justyna M / Lapidus-Krol, Eveline / Fallon, Erica M / Kolivoshka, Yuriy / Fecteau, Annie

    Journal of pediatric surgery

    2021  Volume 57, Issue 4, Page(s) 598–603

    Abstract: Background: I-PASS is a validated and standardized hand-off protocol shown to reduce medical error and improve hand-off efficiency in the pediatric medical population. Our aim was to evaluate the feasibility, effectiveness, accuracy and resident ... ...

    Abstract Background: I-PASS is a validated and standardized hand-off protocol shown to reduce medical error and improve hand-off efficiency in the pediatric medical population. Our aim was to evaluate the feasibility, effectiveness, accuracy and resident satisfaction of implementing I-PASS on a pediatric surgery service.
    Methods: A prospective intervention Quality Improvement (QI approved) study was utilized to evaluate resident written and verbal hand-offs before and after implementation of I-PASS on a pediatric surgery service at a tertiary center. Anonymous surveys were completed by residents following each observation. Results were analyzed using T or Mann-Whitney U Tests and Chi Square.
    Results: A total of 49 written tools and 50 verbal hand-offs were compared pre-and post I-PASS implementation. With I-PASS, increased written accuracy was observed in the documentation of the patient summary (p < 0.05). Accuracy in the verbal hand-off of illness severity, patient summary, contingency plan, action list and synthesis also improved (p < 0.05); but duration of hand-off increased (p < 0.01). Post implementation surveys of residents demonstrated an increased understanding of patient management (p < 0.05).
    Conclusion: Implementing I-PASS on a pediatric surgery service with modifications catered to surgical patients, improved the effectiveness and accuracy of written and verbal patient hand-offs and increased provider satisfaction and preparedness.
    Level of evidence: Level II.
    MeSH term(s) Child ; Communication ; Humans ; Internship and Residency ; Medical Errors ; Patient Handoff ; Prospective Studies
    Language English
    Publishing date 2021-11-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80165-3
    ISSN 1531-5037 ; 0022-3468
    ISSN (online) 1531-5037
    ISSN 0022-3468
    DOI 10.1016/j.jpedsurg.2021.11.015
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    Zs.A 607: Show issues Location:
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  5. Article ; Online: Reducing Underdiagnosis of Hirschsprung-Associated Enterocolitis: A Novel Scoring System.

    Lewit, Ruth A / Veras, Laura V / Cowles, Robert A / Fowler, Kathryn / King, Sebastian / Lapidus-Krol, Eveline / Langer, Jacob C / Park, Christine J / Youssef, Fouad / Vavilov, Sergey / Gosain, Ankush

    The Journal of surgical research

    2021  Volume 261, Page(s) 253–260

    Abstract: Background: Hirschsprung-Associated Enterocolitis (HAEC) is a life-threatening and difficult to diagnose complication of Hirschsprung Disease (HSCR). The goal of this study was to evaluate existing HAEC scoring systems and develop a new scoring system.!# ...

    Abstract Background: Hirschsprung-Associated Enterocolitis (HAEC) is a life-threatening and difficult to diagnose complication of Hirschsprung Disease (HSCR). The goal of this study was to evaluate existing HAEC scoring systems and develop a new scoring system.
    Methods: Retrospective, multi-institutional data collection was performed. For each patient, all encounters were analyzed. Data included demographics, symptomatology, laboratory and radiographic findings, and treatments received. A "true" diagnosis of HAEC was defined as receipt of treatment with rectal irrigations, antibiotics, and bowel rest. The Pastor and Frykman scoring systems were evaluated for sensitivity/specificity and univariate and multivariate logistic regression performed to create a new scoring system.
    Results: Four centers worldwide provided data on 200 patients with 1450 encounters and 369 HAEC episodes. Fifty-seven percent of patients experienced one or more episodes of HAEC. Long-segment colonic disease was associated with a higher risk of HAEC on univariate analysis (OR 1.92, 95% CI 1.43-2.57). Six variables were significantly associated with HAEC on multivariate analysis. Using published diagnostic cutoffs, sensitivity/specificity for existing systems were found to be 38.2%/96% for Pastor's and 56.4%/86.9% for Frykman's score. A new scoring system with a sensitivity/specificity of 67.8%/87.9% was created by stepwise multivariate analysis. The new score outperformed the existing scores by decreasing underdiagnosis in this patient cohort.
    Conclusions: Existing scoring systems perform poorly in identifying episodes of HAEC, resulting in significant underdiagnosis. The proposed scoring system may be better at identifying those underdiagnosed in the clinical setting. Head-to-head comparison of HAEC scoring systems using prospective data collection may be beneficial to achieve standardization in the field.
    MeSH term(s) Enterocolitis/diagnosis ; Enterocolitis/epidemiology ; Enterocolitis/etiology ; Female ; Hirschsprung Disease/complications ; Humans ; Incidence ; Infant ; Male ; Retrospective Studies ; Severity of Illness Index
    Language English
    Publishing date 2021-01-15
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Multicenter Study ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Validation Study
    ZDB-ID 80170-7
    ISSN 1095-8673 ; 0022-4804
    ISSN (online) 1095-8673
    ISSN 0022-4804
    DOI 10.1016/j.jss.2020.12.030
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    Zs.A 178: Show issues Location:
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  6. Article ; Online: Hirschsprung-associated inflammatory bowel disease: A multicenter study from the APSA Hirschsprung disease interest group.

    Sutthatarn, Pattamon / Lapidus-Krol, Eveline / Smith, Caitlin / Halaweish, Ihab / Rialon, Kristy / Ralls, Matthew W / Rentea, Rebecca M / Madonna, Mary B / Haddock, Candace / Rocca, Ana M / Gosain, Ankush / Frischer, Jason / Piper, Hannah / Goldstein, Allan M / Saadai, Payam / Durham, Megan M / Dickie, Belinda / Jafri, Mubeen / Langer, Jacob C

    Journal of pediatric surgery

    2023  Volume 58, Issue 5, Page(s) 856–861

    Abstract: Background/purpose: A small number of Hirschsprung disease (HD) patients develop inflammatory bowel disease (IBD)-like symptoms after pullthrough surgery. The etiology and pathophysiology of Hirschsprung-associated IBD (HD-IBD) remains unknown. This ... ...

    Abstract Background/purpose: A small number of Hirschsprung disease (HD) patients develop inflammatory bowel disease (IBD)-like symptoms after pullthrough surgery. The etiology and pathophysiology of Hirschsprung-associated IBD (HD-IBD) remains unknown. This study aims to further characterize HD-IBD, to identify potential risk factors and to evaluate response to treatment in a large group of patients.
    Methods: Retrospective study of patients diagnosed with IBD after pullthrough surgery between 2000 and 2021 at 17 institutions. Data regarding clinical presentation and course of HD and IBD were reviewed. Effectiveness of medical therapy for IBD was recorded using a Likert scale.
    Results: There were 55 patients (78% male). 50% (n = 28) had long segment disease. Hirschsprung-associated enterocolitis (HAEC) was reported in 68% (n = 36). Ten patients (18%) had Trisomy 21. IBD was diagnosed after age 5 in 63% (n = 34). IBD presentation consisted of colonic or small bowel inflammation resembling IBD in 69% (n = 38), unexplained or persistent fistula in 18% (n = 10) and unexplained HAEC >5 years old or unresponsive to standard treatment in 13% (n = 7). Biological agents were the most effective (80%) medications. A third of patients required a surgical procedure for IBD.
    Conclusion: More than half of the patients were diagnosed with HD-IBD after 5 years old. Long segment disease, HAEC after pull through operation and trisomy 21 may represent risk factors for this condition. Investigation for possible IBD should be considered in children with unexplained fistulae, HAEC beyond the age of 5 or unresponsive to standard therapy, and symptoms suggestive of IBD. Biological agents were the most effective medical treatment.
    Level of evidence: Level 4.
    MeSH term(s) Child ; Humans ; Male ; Infant ; Child, Preschool ; Female ; Hirschsprung Disease/complications ; Hirschsprung Disease/surgery ; Hirschsprung Disease/diagnosis ; Down Syndrome/complications ; Retrospective Studies ; Public Opinion ; Enterocolitis/epidemiology ; Enterocolitis/etiology ; Enterocolitis/diagnosis ; Inflammatory Bowel Diseases/complications ; Biological Factors
    Chemical Substances Biological Factors
    Language English
    Publishing date 2023-01-24
    Publishing country United States
    Document type Multicenter Study ; Journal Article
    ZDB-ID 80165-3
    ISSN 1531-5037 ; 0022-3468
    ISSN (online) 1531-5037
    ISSN 0022-3468
    DOI 10.1016/j.jpedsurg.2023.01.018
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    Zs.A 607: Show issues Location:
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  7. Article ; Online: Requirement and Duration of Tube Feed Supplementation among Congenital Diaphragmatic Hernia Patients.

    Wong, Matthew K W / Haliburton, Beth / Graham, Ashley / Lapidus-Krol, Eveline / Moraes, Theo J / Marcon, Margaret A / Chiu, Priscilla P L

    Journal of pediatric surgery

    2019  Volume 54, Issue 5, Page(s) 895–898

    Abstract: Purpose: Oral feeds pose a challenge for congenital diaphragmatic hernia (CDH) infants. Tube feed (TF) supplementation may be required to support the achievement of normal growth. The aim of this study was to determine the duration and factors ... ...

    Abstract Purpose: Oral feeds pose a challenge for congenital diaphragmatic hernia (CDH) infants. Tube feed (TF) supplementation may be required to support the achievement of normal growth. The aim of this study was to determine the duration and factors associated with TF use in CDH infants at our institution.
    Methods: A single centre retrospective chart review was performed for CDH-born infants who underwent repair between 2000 to 2013 (REB #1000053124). Patient demographics, perinatal management, and feeding status of infants with at least 1-year follow-up were reviewed.
    Results: Of 160 CDH infants, 32 (20%) were discharged on partial or complete TF, and an additional 5 (3.1%) patients started TF post discharge. CDH infants with TF were more likely to have initial arterial blood pH < 7.25, patch repair, ECMO support, and prolonged ICU stay (p < 0.05). Time to TF discontinuation did not differ significantly between those partially or fully TF at discharge. Twelve patients (33.3%) remained TF at their last known follow-up.
    Conclusion: High risk CDH patients are likely to require TF to support their nutritional intake. Parents and caregivers need to be informed and properly supported. Long-term monitoring of CDH patient oral intake, growth, and development will be required.
    Level of evidence/type of study: Level III Retrospective Study.
    MeSH term(s) Enteral Nutrition ; Extracorporeal Membrane Oxygenation ; Follow-Up Studies ; Hernias, Diaphragmatic, Congenital/blood ; Hernias, Diaphragmatic, Congenital/surgery ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn ; Intensive Care Units ; Length of Stay ; Postoperative Period ; Retrospective Studies ; Risk Factors ; Time Factors
    Language English
    Publishing date 2019-01-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80165-3
    ISSN 1531-5037 ; 0022-3468
    ISSN (online) 1531-5037
    ISSN 0022-3468
    DOI 10.1016/j.jpedsurg.2019.01.017
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  8. Article ; Online: Laparoscopy in pediatric surgery: Implementation in Canada and supporting evidence.

    Sattarova, Victoria / Eaton, Simon / Hall, Nigel J / Lapidus-Krol, Eveline / Zani, Augusto / Pierro, Agostino

    Journal of pediatric surgery

    2016  Volume 51, Issue 5, Page(s) 822–827

    Abstract: Background/purpose: The purpose of this study was to assess the diffusion of laparoscopy usage in Canadian pediatric centers and the relationship between uptake of laparoscopic surgery and the level of evidence supporting its use.: Methods: National ... ...

    Abstract Background/purpose: The purpose of this study was to assess the diffusion of laparoscopy usage in Canadian pediatric centers and the relationship between uptake of laparoscopic surgery and the level of evidence supporting its use.
    Methods: National data on four pediatric laparoscopic operations (appendectomy, pyloromyotomy, cholecystectomy, splenectomy) were analyzed using the Canadian Institute for Health Information Discharge Database (2002-2013). The highest level of evidence to support the use of each procedure was identified from Cochrane, Embase, and Pubmed databases. Chi-square test for trend was used to determine significance and time to plateau.
    Results: There were 28,843 operations (open: 12,048; laparoscopic: 16,795). Use of laparoscopic procedures increased over time (p<0.0001). A plateau was reached for cholecystectomy (2006), splenectomy (2007), and appendectomy (2012), but not for pyloromyotomy. Laparoscopic pyloromyotomy in 2013 remains less diffused than the other procedures (p<0.0001). Laparoscopic appendectomy and pyloromyotomy are supported by level-1a evidence in children, whereas cholecystectomy and splenectomy are supported by level-1a evidence in adults but level-3 in children.
    Conclusions: In Canada, it has taken a long time to reach high-level implementation of laparoscopic surgery in children. Laparoscopic cholecystectomy first reached plateau, whereas laparoscopic pyloromyotomy continues to increase but remains low despite high level of evidence in support of its usage compared to open surgery.
    MeSH term(s) Appendectomy/methods ; Appendectomy/statistics & numerical data ; Canada ; Child ; Cholecystectomy, Laparoscopic/statistics & numerical data ; Evidence-Based Medicine ; Hospitals, Pediatric/statistics & numerical data ; Humans ; Laparoscopy/statistics & numerical data ; Pylorus/surgery ; Retrospective Studies ; Splenectomy/methods ; Splenectomy/statistics & numerical data
    Language English
    Publishing date 2016-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80165-3
    ISSN 1531-5037 ; 0022-3468
    ISSN (online) 1531-5037
    ISSN 0022-3468
    DOI 10.1016/j.jpedsurg.2016.02.030
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  9. Article ; Online: Pulmonary hypertension in congenital diaphragmatic hernia patients: Prognostic markers and long-term outcomes.

    Wong, Matthew / Reyes, Janette / Lapidus-Krol, Eveline / Chiang, Monping / Humpl, Tilman / Al-Faraj, Malikah / Ryan, Greg / Chiu, Priscilla P L

    Journal of pediatric surgery

    2018  Volume 53, Issue 5, Page(s) 918–924

    Abstract: Prenatal observed/expected lung-to-head ratio (O/E LHR) by ultrasound correlates with postnatal mortality for congenital diaphragmatic hernia (CDH) patients. The aim of this study is to determine if O/E LHR correlates with pulmonary hypertension (PH) ... ...

    Abstract Prenatal observed/expected lung-to-head ratio (O/E LHR) by ultrasound correlates with postnatal mortality for congenital diaphragmatic hernia (CDH) patients. The aim of this study is to determine if O/E LHR correlates with pulmonary hypertension (PH) outcomes for CDH patients.
    Methods: A single center retrospective chart review was performed for CDH neonates from January 1, 2006, to December 31, 2015, (REB #1000053124) to include prenatal O/E LHR, liver position, first arterial blood gas, repair type, echocardiogram (ECHO), and lung perfusion scan (LPS) results up to 5years of age.
    Results: Of 153 newborns, 123 survived (80.4%), 58 (37.9%) had prenatal O/E LHR, and 42 (27.5%) had postnatal ECHO results. High mortality risk neonates (O/E LHR ≤45%) correlated with higher right ventricular systolic pressure (RVsp) at birth. Generally PH resolved by age 5years. LPS results did not change over time (p>0.05) regardless of initial PH severity, suggesting that PH resolution did not correlate with increased ipsilateral lung perfusion to offload the right ventricle.
    Conclusion: Prenatal prognostic markers correlated with initial PH severity for CDH newborns, but PH resolved over time despite fixed perfusion bias to the lungs. These results suggest favorable PH outcomes for CDH patients who survive beyond infancy.
    Type of study: Retrospective Cohort Study.
    Level of evidence: 3b.
    MeSH term(s) Echocardiography/methods ; Female ; Follow-Up Studies ; Gestational Age ; Hernias, Diaphragmatic, Congenital/complications ; Hernias, Diaphragmatic, Congenital/diagnosis ; Hernias, Diaphragmatic, Congenital/mortality ; Humans ; Hypertension, Pulmonary/diagnosis ; Hypertension, Pulmonary/etiology ; Hypertension, Pulmonary/mortality ; Infant ; Infant Mortality/trends ; Infant, Newborn ; Male ; Ontario/epidemiology ; Pregnancy ; Prognosis ; Retrospective Studies ; Time Factors ; Ultrasonography, Prenatal/methods
    Language English
    Publishing date 2018-02-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80165-3
    ISSN 1531-5037 ; 0022-3468
    ISSN (online) 1531-5037
    ISSN 0022-3468
    DOI 10.1016/j.jpedsurg.2018.02.015
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  10. Article ; Online: Neurodevelopmental outcomes of infants with esophageal atresia and tracheoesophageal fistula.

    Mawlana, Wegdan / Zamiara, Paul / Lane, Hilary / Marcon, Margaret / Lapidus-Krol, Eveline / Chiu, Priscilla Pl / Moore, Aideen M

    Journal of pediatric surgery

    2018  Volume 53, Issue 9, Page(s) 1651–1654

    Abstract: Background: Esophageal atresia with or without tracheoesophageal fistula (EA/TEF) is a complex disorder, and most outcome data are confined to mortality and feeding-related morbidities. Our objective was to examine mortality, growth and ... ...

    Abstract Background: Esophageal atresia with or without tracheoesophageal fistula (EA/TEF) is a complex disorder, and most outcome data are confined to mortality and feeding-related morbidities. Our objective was to examine mortality, growth and neurodevelopmental outcomes in a large recent cohort of infants with EA/TEF.
    Methods: Single center study of EA/TEF infants referred from January 2000 to December 2015. Data collected included associated defects, neonatal morbidity and mortality and growth and neurodevelopmental outcomes at age 12-36months. Multiple regression analysis was used to determine variables associated with adverse outcome.
    Results: Of the 253 infants identified, 102 infants (40%) were preterm. Overall mortality was 8.3%, the majority from major cardiac malformations (p<0.001) Neurodevelopmental assessments (n=182) showed that 76% were within normal, while some delay was seen in 24%, most often in expressive and receptive language. Nine infants had hearing impairment and 5 had visual impairment. Gastrostomy tubes were required in 47 patients and 15% continued to have weight growth velocities less than the 10th centile. A number of specialist interventions were required, Speech/Language being frequent.
    Conclusion: Mortality in EA/TEF is primarily related to concomitant anomalies, especially cardiac. Multidisciplinary follow up is important for early identification and intervention for growth failure and developmental delay.
    Type of study: Retrospective study LEVEL OF EVIDENCE: Level II.
    MeSH term(s) Child, Preschool ; Esophageal Atresia/complications ; Esophageal Atresia/mortality ; Esophageal Atresia/physiopathology ; Esophageal Atresia/surgery ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Male ; Neurodevelopmental Disorders/diagnosis ; Neurodevelopmental Disorders/etiology ; Neurodevelopmental Disorders/therapy ; Retrospective Studies ; Tracheoesophageal Fistula/complications ; Tracheoesophageal Fistula/mortality ; Tracheoesophageal Fistula/physiopathology ; Tracheoesophageal Fistula/surgery ; Treatment Outcome
    Language English
    Publishing date 2018-01-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80165-3
    ISSN 1531-5037 ; 0022-3468
    ISSN (online) 1531-5037
    ISSN 0022-3468
    DOI 10.1016/j.jpedsurg.2017.12.024
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 607: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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