Investigation of the determinacy of proximal and distal esophageal dimensions and the distance between both segments for delayed repair in children with isolated esophageal atresia

Patients with isolated esophageal atresia (EA) that have been following in Hacettepe University, Faculty of Medicine, Department of Pediatric Surgery, between 2000-2018, have been evaluated to define the role of distance between proximal and distal esophagus on surgical technique and postoperative complications retrospectively. The demographic features of patients including age, sex, gestational week, birth weight and associated anomalies were obtained from hospital records. Upper and lower pouch length and distance between pouches was measured with a proposed measurement method. Patients were divided into delayed primary repair (DPR) and esophageal replacement (ER) groups according to surgical technique. Fourteen cases with a mean age of 4,1±1,9 years (1-9 years) were included. Six of the cases were female (42,9%) and 8 of them were male (57,1%). There was no difference between DPR and ER groups in terms of age, sex, age of mother, birth weight and gestational week (p>0,05). Although, there was no significant difference between DPR and ER groups for upper and lower pouch measurements, distance between pouches were significantly higher in ER group (median; 50 mm, min:29,4-max: 83,6 ) when compared to DPR (median; 18.8 mm, min:3,4-max: 34,5) (p<0.05). There was no difference in patients with and without anastomotic strictures (p>0,05). In conclusion, although both upper and lower pouch lengths were shorter in ER group with respect to DPR group, pouch lengths were not determinative for surgical technique. However, the distance between two pouches is a significant parameter to define the surgical option, large cohort of patients needed to define which length is decisive for choosing an appropriate surgical technique.