TY - JOUR
T1 - VACTERL associations in children undergoing surgery for esophageal atresia and anorectal malformations
T2 - Implications for pediatric surgeons
AU - Lautz, Timothy B.
AU - Mandelia, Ankur
AU - Radhakrishnan, Jayant
N1 - Publisher Copyright:
© 2015 Elsevier Inc. All rights reserved.
PY - 2014/8/6
Y1 - 2014/8/6
N2 - Purpose The aim of this study was to compare the frequency and nature of VACTERL associations between children who underwent surgery for esophageal atresia/tracheoesophageal fistula (EA/TEF) and anorectal malformation (ARM). Methods We identified all children who underwent surgery for EA/TEF and/or ARM at hospitals participating in the Pediatric Health Information System (PHIS) database between 2004 and 2012. PHIS is an administrative database of free-standing children's hospitals managed by the Child Health Corporation of America (Overland Park, KS) that contains patient-level care data from 43 hospitals. The complete records of patients in this cohort were cross-referenced for diagnoses of vertebral, cardiac, renal and limb anomalies. Results 2689 children underwent repair of esophageal atresia. Mean gestational age was 36.5 ± 3.2 weeks and mean birth weight was 2536.0 ± 758.7 g. Associated VACTERL diagnoses included vertebral anomaly in 686 (25.5%), ARM in 312 (11.6%), congenital heart disease in 1588 (59.1%), renal disease in 587 (21.8%) and limb defect in 192 (7.1%). 899 (33.4%) had 3 or more anomalies and met criteria for a VACTERL diagnosis. 4962 children underwent repair of ARM. Mean gestational age was 37.4 ± 2.7 weeks and mean birth weight was 2895.2 ± 765.1 g. Associated VACTERL diagnoses included vertebral anomaly in 1562 (31.5%), congenital heart disease in 2007 (40.4%), EA/TEF in 348 (7.0%), renal disease in 1723 (34.7%) and limb defect in 359 (7.2%). 1795 (36.2%) had 3 or more anomalies and met criteria for a VACTERL diagnosis. Conclusion VACTERL associations are relatively common in children with EA/TEF and ARM and occur in specific clusters, with cardiac disease more common in EA/TEF and spinal and renal/urinary anomalies more common in ARM.
AB - Purpose The aim of this study was to compare the frequency and nature of VACTERL associations between children who underwent surgery for esophageal atresia/tracheoesophageal fistula (EA/TEF) and anorectal malformation (ARM). Methods We identified all children who underwent surgery for EA/TEF and/or ARM at hospitals participating in the Pediatric Health Information System (PHIS) database between 2004 and 2012. PHIS is an administrative database of free-standing children's hospitals managed by the Child Health Corporation of America (Overland Park, KS) that contains patient-level care data from 43 hospitals. The complete records of patients in this cohort were cross-referenced for diagnoses of vertebral, cardiac, renal and limb anomalies. Results 2689 children underwent repair of esophageal atresia. Mean gestational age was 36.5 ± 3.2 weeks and mean birth weight was 2536.0 ± 758.7 g. Associated VACTERL diagnoses included vertebral anomaly in 686 (25.5%), ARM in 312 (11.6%), congenital heart disease in 1588 (59.1%), renal disease in 587 (21.8%) and limb defect in 192 (7.1%). 899 (33.4%) had 3 or more anomalies and met criteria for a VACTERL diagnosis. 4962 children underwent repair of ARM. Mean gestational age was 37.4 ± 2.7 weeks and mean birth weight was 2895.2 ± 765.1 g. Associated VACTERL diagnoses included vertebral anomaly in 1562 (31.5%), congenital heart disease in 2007 (40.4%), EA/TEF in 348 (7.0%), renal disease in 1723 (34.7%) and limb defect in 359 (7.2%). 1795 (36.2%) had 3 or more anomalies and met criteria for a VACTERL diagnosis. Conclusion VACTERL associations are relatively common in children with EA/TEF and ARM and occur in specific clusters, with cardiac disease more common in EA/TEF and spinal and renal/urinary anomalies more common in ARM.
KW - Anorectal malformation
KW - Esophageal atresia
KW - Trachea-esophageal fistula
KW - VACTERL
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U2 - 10.1016/j.jpedsurg.2015.02.049
DO - 10.1016/j.jpedsurg.2015.02.049
M3 - Article
C2 - 25913268
AN - SCOPUS:84955178037
VL - 50
SP - 1245
EP - 1250
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 8
ER -