Journal of Clinical Pediatrics >

2023 , Vol. 41 >Issue 1: 18 - 24

DOI: https://doi.org/10.12372/jcp.2023.22e1230

Intrauterine Pediatrics

Application of clinical swallowing evaluation in the treatment of long-gap esophageal atresia children

  • Junli WANG ,
  • Wenjie WU ,
  • Chunyan TANG ,
  • Ning ZHANG ,
  • Jun WANG ,
  • Fei LI
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  • 1. Developmental and Behavioral Pediatric Department & Child Primary Care Department, MOE-Shanghai Key Laboratory for Children’s Environmental Health

Received date: 2022-09-19

  Online published: 2023-02-16

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Abstract

Objective To analyze the effect of clinical swallow evaluation (CSE) on the complications and growth of children with long gap esophageal atresia (LGEA) within 24 months of age. Methods The clinical data of children who underwent LGEA surgery from January 2016 to January 2022 were retrospectively analyzed. Children with LGEA who had regular CSE follow-up were included in the CSE group and those who did not participate in CSE were included in the control group. The incidence of complications and the growth of children within 24 months were compared between the two groups. Results A total of 50 children with LGEA were included in the analysis. There were 19 children (11 boys and 8 girls) in the CSE group, including 16 cases of type Ⅰ congenital esophageal atresia (2 cases with fistula), 2 cases of type Ⅱ and 1 case of type Ⅲa. Twelve children received prenatal diagnosis. In the control group, there were 31 children (16 boys and 15 girls), including 28 cases of typeⅠand 3 cases of type Ⅱ (2 cases with fistula). Prenatal diagnosis was obtained in 21 cases. The birth weight of the CSE group was lower than that of the control group, the difference distance of the blind end of the esophagus was longer than that of the control group, and the difference was significant (P<0.05). The interval from postoperative to complete oral feeding was 34.0 (22.0-76.0) days in the CSE group and 46.0 (18.0-181.0) days in the control group, and the difference was statistically significant (Z=2.30, P=0.028). Compared with the control group, the CSE group had a lower incidence of lung infection, lower weight-for-age z score (WAZ) and lower length-for-age z score (LAZ) at 6 months. The detection rates of underweight and stunting in the CSE group at 24 months were lower than those in the control group, and the differences were statistically significant (P<0.05). The increment value of LAZ in the CSE group at 24 months was higher than that in the control group, and the difference was statistically significant (P<0.05).Conclusions Regular CSE follow-up in the long-term treatment of children with LGEA can reduce the incidence of lung infection within 24 months of age, and is conducive to early postoperative complete oral feeding and weight and height catch-up.

Key words： long-gap esophageal atresia; clinical swallow evaluation; pulmonary infection; nutritional status

Cite this article

Junli WANG , Wenjie WU , Chunyan TANG , Ning ZHANG , Jun WANG , Fei LI . Application of clinical swallowing evaluation in the treatment of long-gap esophageal atresia children[J]. Journal of Clinical Pediatrics, 2023 , 41(1) : 18 -24 . DOI: 10.12372/jcp.2023.22e1230

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