Resumen

SALAS, Ariel A. et al. Atresia de esófago: experiencia en el Hospital del Niño - La Paz - Bolivia. Cuad. - Hosp. Clín. [online]. 2007, vol.52, n.1, pp. 55-59. ISSN 1652-6776.

BACKGROUND: Esophageal atresia (EA) is a rare condition with high mortality and morbidity rates.   AIM To determine clinical and demographic features of patients with EA and to establish the main conditions associated with a good final outcome through comparative analysis between urgent surgical approach and elective and programmed surgical approach.   METHODS                                                                                                       We performed a retrospective chart review of patients diagnosed with EAadmitted to PICU during January 2000 and December 2004 at the Children’s Hospital “Dr Ovidio Aliaga U.” Simultaneously, we evaluated the impact of a new management guideline on survival rate during the last two years.   RESULTS Nineteen patients were evaluated (n=19). Mean birth weight was 2671 g and the average gestational age was 37wk. Referral conditions were inappropriate in many cases. Main signs and symptoms were respiratory distress (84.2%), food intolerance (78.9%), excessive salivation (73.7%) and cyanosis (52.6%). 84% of cases were EA with tracheo-esophageal fistula. Other associated congenital malformations were observed in 63% of patients and congenital heart disease was the most common finding (41%). The new guideline for management reduced mortality rate from 72.7% to 25%   CONCLUSIONS An elective and programmed surgical approach improves the survival rate among patients with EA. Referral conditions and early diagnosis must be improved in our setting.

Palabras llave : Esophageal atresia; Congenital malformations; Management protocol; Elective surgical focus; Emergency in newborns.