Outcome of surgical treatment of esophageal atresia and it’s associated factors among newborns at FMIC Hospital Kabul Afghanistan
Date of Award
Diploma in Paediatric Surgery
French Medical Institute for Children
Introduction: Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a condition resulting from abnormal development before birth of the tube that carries food from the mouth to the stomach (the esophagus). Over the passage of time, there is a modification in treatment modialities that has enhanced the overall outcome of disease. It is also recognized that prompt diagnosis with appropriate clinical management and expeditious referral to a tertiary care center had a dramatic impact on the improved survival of these infants. Hence, this study aimed to determine the outcomes of surgical treatment of “Esophageal Atresia” with or without “TrachioEsophageal Fistula” among newborn at French Medical Institute for children, Kabul, Afghanistan.
Methodology: An analytical retesrospective hospital based research study was conducted to accomplish study objectives. Records of 165 newborns who were admitted with EA/TEF and had undergone survey at French Medical Institute for Children (FMIC), Kabul, Afghanistan were reviewed. Data was collected through a self-developed structured questionnaire. Data was analyzed with the help of Statisitical Package for Social Sciences version 19.0. Chi-square test of independence was run and P-value was computed to determine an association between factors and outcome of EA/TEF among newbrons.
Results: A total of 165 newborns who were admitted with the diagnosis of Esophageal Atresia with or without Trachoe-Esophageal Fistula and undergone surgery were recruited in this study. Most of the study participants (61.21%) were males. Majority of the cases (69.09%) had birth weight of 2 to 3 kg and had type “C” classification of EA+TEF. In terms of their ages at the time of surgery, most of them were aged less than 1 week during the surgical procedure. Around 31% of the cases had an associated anomaly VACTERL. Around 69% of the cases had survived post surgery. Most of the cases had developed complication like: stenosis, fistula and recurrence. With regard to length of stay during treatment, around 83% of newborns stayed for more than 10 days. This study has manisfested that weight, presence of anomaly VACTERL, and complications after surgery were significantly associated with outcome of Surgical procedure among newborns with the diagnosis of EA+TEF admitted to FMIC hospital.
Conclusion: The condition of EA+TEF is quite prevalent among newborns in Afghanistan. Weight of newborn, presence of anomaly VACETRL , and complication were found as a significant determinants of outcomes of surgery for newborns with EA+TEF. It is important to design interventions which could help in improving the outcomes of surgery and reduce the risk of mortality among newborns. The high incidence of low birth weight, delayed diagnosis, poor referral, and lack of advanced neonatological back up are important contributory factors to poor outcome.
Akbary, B. (2016). Outcome of surgical treatment of esophageal atresia and it’s associated factors among newborns at FMIC Hospital Kabul Afghanistan (Unpublished doctoral thesis). FMIC, Kabul, Afghanistan.