@article{c8febbb1c4a2450b9d3fa371625c1f2e,
title = "Acid suppression duration does not alter anastomotic stricture rates after esophageal atresia with distal tracheoesophageal fistula repair: A prospective multi-institutional cohort study",
abstract = "Introduction: Anastomotic stricture is the most common complication after esophageal atresia (EA) repair. We sought to determine if postoperative acid suppression is associated with reduced stricture formation. Methods: A prospective, multi-institutional cohort study of infants undergoing primary EA repair from 2016 to 2020 was performed. Landmark analysis and multivariate Cox regression were used to explore if initial duration of acid suppression was associated with stricture formation at hospital discharge (DC), 3-, 6-, and 9-months postoperatively. Results: Of 156 patients, 79 (51%) developed strictures and 60 (76%) strictures occurred within three months following repair. Acid suppression was used in 141 patients (90%). Landmark analysis showed acid suppression was not associated with reduction in initial stricture formation at DC, 3-, 6- and 9-months, respectively (p = 0.19–0.95). Multivariate regression demonstrated use of a transanastomotic tube was significantly associated with stricture formation at DC (Hazard Ratio (HR) = 2.21 (95% CI 1.24–3.95, p<0.01) and 3-months (HR 5.31, 95% CI 1.65–17.16, p<0.01). There was no association between acid suppression duration and stricture formation. Conclusion: No association between the duration of postoperative acid suppression and anastomotic stricture was observed. Transanastomotic tube use increased the risk of anastomotic strictures at hospital discharge and 3 months after repair.",
keywords = "Acid suppression, Anastomotic stricture, Esophageal atresia, Tracheoesophageal fistula",
author = "{Midwest Pediatric Consortium} and Bowder, {Alexis N.} and Bence, {Christina M.} and Rymeski, {Beth A.} and Gadepalli, {Samir K.} and Sato, {Thomas T.} and Aniko Szabo and Arendonk, {Kyle Van} and Minneci, {Peter C.} and Downard, {Cynthia D.} and Hirschl, {Ronald B.} and Troy Markel and Courtney, {Cathleen M.} and Deans, {Katherine J.} and Fallat, {Mary E.} and Fraser, {Jason D.} and Grabowski, {Julia E.} and Helmrath, {Michael A.} and Kabre, {Rashmi D.} and Kohler, {Jonathan E.} and Landman, {Matthew P.} and Lawrence, {Amy E.} and Leys, {Charles M.} and Grace Mak and Elissa Port and Jacqueline Saito and Jared Silverberg and Slidell, {Mark B.} and {St Peter}, {Shawn D.} and Misty Troutt and Wright, {Tiffany N.} and Lal, {Dave R.}",
note = "Funding Information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors thank Huaying Dong, for their contributions to the statistical methods and data analysis for this project. MWPSC Institutions: CS Mott Children's Hospital, Lurie Children's Hospital, Comer Children's Hospital, Cincinnati Children's Hospital and Medical Center, Nationwide Children's Hospital, Riley Hospital for Children, Children's Mercy Hospital, Norton Children's Hospital, American Family Children's Hospital, St. Louis Children's Hospital, and Children's Wisconsin, Type of Study: Prospective Observational Cohort Publisher Copyright: {\textcopyright} 2022 Elsevier Inc.",
year = "2022",
month = jun,
doi = "10.1016/j.jpedsurg.2022.02.004",
language = "English",
volume = "57",
pages = "975--980",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
number = "6",
}