LONG-TERM FUNCTIONAL AND RESPIRATORY OUTCOMES AFTER ESOPHAGEAL ATRESIA REPAIR: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.56238/levv16n54-088Keywords:
Esophageal Atresia, Respiratory Function, Long-Term Outcomes, Quality of LifeAbstract
Introduction: Esophageal atresia (EA) is a congenital malformation that remains associated with significant long-term morbidity despite improved survival. Post-repair complications such as tracheomalacia, chronic cough, dysphagia, and recurrent respiratory infections can persist throughout life, emphasizing the importance of multidisciplinary and prolonged follow-up.
Objective: To systematically review the available evidence on long-term functional and respiratory outcomes after surgical repair of esophageal atresia, integrating data from recent clinical studies to identify predictors, management strategies, and implications for lifelong care.
Methods: A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, LILACS, ClinicalTrials.gov, and ICTRP. Studies from the past five years were prioritized, with extension to ten years if fewer than ten eligible articles were found. Human studies were included; animal and in vitro studies were analyzed separately. Methodological quality was assessed using RoB 2, ROBINS-I, and QUADAS-2, and certainty of evidence was graded with GRADE criteria.
Results and Discussion: Twenty studies met the inclusion criteria. Persistent respiratory morbidity and reduced lung function were observed in most cohorts, regardless of surgical technique. Primary tracheopexy and airway pexy improved airway stability in selected patients. Quality of life assessments demonstrated ongoing functional limitations and psychosocial distress. Evidence heterogeneity was moderate, and certainty ranged from low to moderate. Despite improved perioperative care, the burden of chronic respiratory and gastrointestinal sequelae remains substantial.
Conclusion: Survivors of esophageal atresia repair frequently experience long-term functional and respiratory complications. Continuous multidisciplinary follow-up, standardized outcome measures, and registry-based research are essential to optimize prognosis and guide individualized management.
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