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Langzeitmorbidität und Transition von Kindern mit Ösophagusatresie

Long-term morbidity and transition of children with esophageal atresia

  • Pädiatrische Pneumologie
  • Published:
Zeitschrift für Pneumologie Aims and scope

Zusammenfassung

Fast täglich wird in Deutschland ein Kind mit Ösophagusatresie (ÖA) geboren. Die Gesamtüberlebensrate hat sich in den letzten Jahrzehnten signifikant verbessert. Auch nach einer erfolgreichen Operation haben Patienten mit ÖA häufig lebenslange Beschwerden. Zu diesen gehören Motilitätsstörungen des Ösophagus mit Dysphagie, gastroösophageale Refluxerkrankung, rezidivierende und chronische Atemwegserkrankungen, Gedeihstörungen, muskuloskeletale Probleme, psychosoziale Beeinträchtigungen und Einschränkungen der Lebensqualität. Daraus ergeben sich ständig neue Herausforderungen in der Betreuung von langzeitlichen Komorbiditäten und Folgeerkrankungen. Insbesondere die Transition jugendlicher Patienten in die Erwachsenenmedizin gestaltet sich durch den Mangel an einheitlichen Empfehlungen und Ressourcen schwierig. Dieser Beitrag gibt eine Übersicht über die wichtigsten Morbiditäten von Patienten mit ÖA und fasst die relevante Diagnostik sowie Therapie zusammen. Dabei werden respiratorische Erkrankungen besonders berücksichtigt. Ziel ist es, eine erfolgreiche interdisziplinäre Nachsorge von Jugendlichen und Erwachsenen mit ÖA zu gewährleisten.

Abstract

Almost every day a child is born in Germany with esophageal atresia (EA). The overall survival rate has significantly improved over the last decades; however, even after successful surgical repair, patients with EA frequently have lifelong complaints. These include esophageal dysmotility with dysphagia, gastroesophageal reflux disease, recurrent and chronic respiratory diseases, failure to thrive, musculoskeletal problems, psychosocial impairments and reduced quality of life. This results in new challenges in the care of long-term comorbidities and sequelae. The transition of adolescents to adult care, in particular, currently remains difficult due to the lack of uniform recommendations and resources. This article aims to review the most important morbidities of patients with EA and summarizes the relevant diagnostic and treatment approaches. Special consideration is given to respiratory diseases. The aim is to ensure a successful interdisciplinary aftercare of adolescents and adults with EA.

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Authors and Affiliations

  1. Klinik und Poliklinik für Kinderchirurgie, Universitätsklinikum Leipzig, Liebigstr. 20A, 04103, Leipzig, Deutschland

    Ophelia Aubert, Martin Lacher &  Steffi Mayer

  2. Abteilung für Pädiatrische Pneumologie und Allergologie, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Leipzig, Leipzig, Deutschland

    Freerk Prenzel

  3. Abteilung für Wirbelsäulenchirurgie, Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, Leipzig, Deutschland

    Christoph-Eckhard Heyde

  4. Abteilung für Gastroenterologie, Klinik und Poliklinik für Onkologie, Gastroenterologie, Hepatologie, Pneumologie und Infektiologie, Universitätsklinikum Leipzig, Leipzig, Deutschland

    Albrecht Hoffmeister

  5. Abteilung für Pädiatrische Gastroenterologie, Hepatologie, Ernährung und Psychosomatik, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Leipzig, Leipzig, Deutschland

    Gunter Flemming

  6. Klinik und Poliklinik für Viszeral‑, Transplantations‑, Thorax- und Gefäßchirurgie, Department für Operative Medizin (DOPM), Universitätsklinikum Leipzig, Leipzig, Deutschland

    Ines Gockel

  7. Institut für Kinderradiologie, Universitätsklinikum Leipzig, Leipzig, Deutschland

    Daniel Gräfe

  8. Klinik und Poliklinik für Psychiatrie, Psychotherapie und Psychosomatik des Kindes- und Jugendalters, Universitätsklinikum Leipzig, Leipzig, Deutschland

    Franziska Schlensog-Schuster

  9. Patienten- und Selbsthilfeorganisation für Kinder & Erwachsene mit kranker Speiseröhre, KEKS e. V., Bundesgeschäftsstelle, KEKS e. V., Stuttgart, Deutschland

    Stephan Jechalke

  10. Esophageal Atresia Global Support Groups, EAT e. V., Stuttgart, Deutschland

    Anke Widenmann-Grolig

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  1. Ophelia Aubert
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  2. Freerk Prenzel
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Correspondence to Steffi Mayer.

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O. Aubert, F. Prenzel, C.-E. Heyde, A. Hoffmeister, G. Flemming, I. Gockel, D. Gräfe, F. Schlensog-Schuster, S. Jechalke, A. Widenmann-Grolig, M. Lacher und S. Mayer geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Für Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, über die Patient/-innen zu identifizieren sind, liegt von ihnen und/oder ihren gesetzlichen Vertretern/Vertreterinnen eine schriftliche Einwilligung vor.

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Aubert, O., Prenzel, F., Heyde, CE. et al. Langzeitmorbidität und Transition von Kindern mit Ösophagusatresie. Z Pneumologie 19, 392–402 (2022). https://doi.org/10.1007/s10405-022-00471-z

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