Perioperative anaesthetic management and short-term outcome of neonatal repair of oesophageal atresia with or without tracheo-oesophageal fistula in Europe: A sub-analysis of the neonate and children audit of anaesthesia practice in Europe (NECTARINE) prospective multicenter observational study

Eur J Anaesthesiol. 2023 Dec 1;40(12):936-945. doi: 10.1097/EJA.0000000000001905. Epub 2023 Sep 28.

Abstract

Background: Oesophageal atresia with or without a tracheo-oesophageal fistula is a congenital abnormality that usually requires surgical repair within the first days of life.

Objective: Description of the perioperative anaesthetic management and outcomes of neonates undergoing surgery for oesophageal atresia with or without a tracheo-oesophageal fistula, included in the 'neonate and children audit of anaesthesia practice in Europe' (NECTARINE) database.

Design: Sub-analyses of prospective observational NECTARINE study.

Setting: European multicentre study.

Patients: Neonates who underwent surgery for oesophageal atresia with or without a tracheo-oesophageal fistula in the NECTARINE cohort were selected.

Main outcome measures: Incidence rates with 95% confidence intervals were calculated for peri-operative clinical events which required a predetermined intervention, postoperative complications, and mortality.

Results: One hundred and three neonates undergoing a first surgical intervention for oesophageal atresia with or without a tracheo-oesophageal fistula repair were identified. Their median gestational age was 38 weeks with a median birth weight of 2840 [interquartile range 2150 to 3150] grams. Invasive monitoring was used in 66% of the procedures. The incidence of perioperative clinical events was 69% (95% confidence interval 59 to 77%), of 30-day postoperative complications 47% (95% confidence interval 38 to 57%) and the 30- and 90 days mortality rates were 2.1% and 2.6%, respectively.

Conclusion: Oesophageal atresia with or without a tracheo-oesophageal fistula repair in neonates is associated with a high number of perioperative interventions in response to clinical events, a high incidence of postoperative complications, and a substantial mortality rate.

Publication types

  • Observational Study
  • Multicenter Study

MeSH terms

  • Anesthesia*
  • Anesthetics*
  • Esophageal Atresia* / complications
  • Esophageal Atresia* / surgery
  • Humans
  • Infant
  • Infant, Newborn
  • Postoperative Complications / epidemiology
  • Prospective Studies
  • Tracheoesophageal Fistula* / diagnosis
  • Tracheoesophageal Fistula* / epidemiology
  • Tracheoesophageal Fistula* / surgery

Substances

  • Anesthetics