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Impact of congenital heart disease on outcomes after primary repair of esophageal atresia: a retrospective observational study using a nationwide database in Japan

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Abstract

Purpose

To verify the association between congenital heart disease (CHD) and postoperative complications after primary repair of esophageal atresia in patients from a Japanese nationwide database.

Methods

We identified babies in the Diagnosis Procedure Combination database who underwent radical surgery for esophageal atresia from 2010 to 2016. We used multivariable logistic regression analyses to evaluate the occurrence of anastomotic leakage and anastomotic stricture.

Results

Among 431 patients who underwent primary anastomosis, 114 patients (27%) had CHD. Anastomotic leakage occurred in 77 patients (17.9%) and stricture in 154 (35.7%). Compared with patients whose anesthetic duration was less than 240 min, those with anesthesia lasting from 240 to 360 min (odds ratio 2.49; 95% confidence interval (CI) 1.17–5.27; p = 0.02) or more than 360 min (odds ratio 4.10; 95% CI 1.69–9.96; p = 0.002) were more likely to experience anastomotic leakage. Male patients had a lower risk of anastomotic stricture than female patients (odds ratio 0.65; 95% CI 0.43–0.9; p = 0.04).

Conclusions

CHD was not associated with anastomotic leakage or stricture. The only significant predictor of anastomotic leakage was duration of anesthesia.

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Funding

This work was supported by grants from the Ministry of Health, Labour and Welfare, Japan (H29-Policy-Designated-009 and H29-ICT-Genral-004) and the Ministry of Education, Culture, Sports, Science and Technology, Japan (17H04141).

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Authors and Affiliations

  1. Department of Pediatric Surgery, Saitama Children’s Medical Center, 1-2 Shintoshin, Chuo-ku, Saitama, 330-8777, Japan

    Tetsuya Ishimaru & Hiroshi Kawashima

  2. Department of Pediatric Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Michimasa Fujiogi & Jun Fujishiro

  3. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan

    Michimasa Fujiogi, Hiroki Matsui & Hideo Yasunaga

  4. Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Nobuaki Michihata

  5. Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, Tokyo, Japan

    Kiyohide Fushimi

Authors
  1. Tetsuya Ishimaru
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  2. Michimasa Fujiogi
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  3. Nobuaki Michihata
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  4. Hiroki Matsui
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  5. Kiyohide Fushimi
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  6. Hiroshi Kawashima
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  7. Jun Fujishiro
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  8. Hideo Yasunaga
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Correspondence to Tetsuya Ishimaru.

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Ishimaru, T., Fujiogi, M., Michihata, N. et al. Impact of congenital heart disease on outcomes after primary repair of esophageal atresia: a retrospective observational study using a nationwide database in Japan. Pediatr Surg Int 35, 1077–1083 (2019). https://doi.org/10.1007/s00383-019-04542-w

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  • DOI: https://doi.org/10.1007/s00383-019-04542-w

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