Zeitschrift für Kindermedizin und Chirurgie

Abstrakt

Pediatrics 2018: Outcome of the Surgical Treatment of Esophageal Atresia and its Associated Factors Among Newborn at French Medical Institute for Mothers And Children (FMIC) Hospital Kabul Afghanistan - Mohammad Tareq Rahimi - French Medical Institute for Children (FMIC)

Mohammad Tareq Rahimi and Bashir Akbari

Introduction:  Esophageal atresia (EA) is an uncommon birth deformity where an infant is conceived without part of the throat (the cylinder that associates the mouth to the stomach). Rather than framing a cylinder between the mouth and the stomach, the throat develops in two separate sections that don't associate. EA often happens alongside tracheoesophageal fistula (TEF), and the same number of as half of all children with EA/TEF have another birth imperfection, also. Without a working throat, it's difficult to get enough sustenance by mouth. Infants with EA are additionally progressively inclined to diseases like pneumonia and conditions, for example, heartburn.

There are four sorts of esophageal atresia (EA): Type A: The upper and lower sections of the throat end in pockets, similar to impasse lanes that don't interface. Tracheoesophageal fistula (TEF) is absent. Type B: The lower portion finishes in a visually impaired pocket. TEF is available on the upper fragment. This sort is uncommon. Type C: The upper portion finishes in a visually impaired pocket. TEF is available on the lower portion. This is the most widely recognized sort. Type D: TEF is available on both upper and lower fragments. This is the rarest type of EA/TEF.

EA and TEF are likewise regularly found in babies brought into the world with VACTERL (vertebral deformities, butt-centric atresia, cardiovascular imperfections, tracheo-esophageal fistula, renal oddities and appendage anomalies) disorder. Not all infants brought into the world with VACTERL disorder have irregularities in these zones. Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a condition coming about because of strange advancement before birth of the cylinder that conveys food from the mouth to the stomach (the throat). It is an uncommon intrinsic inconsistency lacking contemporary information enumerating understanding socioeconomics, clinical/careful administration and results. Generous variety being taken care of by newborn children with EA/TEF may influence both short-and long haul results.

Over the progression of time, there is an adjustment in treatment modalities that has improved the general result of malady. It is likewise perceived that speedy conclusion with fitting clinical administration and quick referral to a tertiary consideration place dramatically affected the improved endurance of these babies. Subsequently, this examination planned to decide the results of careful treatment of esophageal atresia with or without TEF among new-conceived at French Medical Institute for youngsters, Kabul, Afghanistan.

Strategy: An expository review medical clinic based research study was led to achieve study targets. Records of 165 new-borns that were conceded with EA/TEF and had experienced overview at French Medical Institute for Children (FMIC), Kabul, Afghanistan were inspected. Information was gathered through a self-created organized poll. Information was dissected with the assistance of Statistical Package for Social Sciences adaptation 19.0. Chi-square trial of autonomy was run and P-esteem was figured to decide a relationship among components and result of EA/TEF among new-borns.

 Results: A sum of 165 new-borns who were conceded with the determination of EA with or without TEA and experienced medical procedure were enlisted in this investigation. The majority of the investigation members (61.21%) were guys. Dominant part of the cases (69.09%) had birth weight of 2 to 3 kg and had type "C" characterization of EA+TEF. As far as their ages at the hour of medical procedure, most of them were matured under multi week during the surgery. Around 31% of the cases had a related oddity VACTERL. Around 69% of the cases had endured post-medical procedure. The vast majority of the cases had created intricacy like stenosis, fistula and repeat. With respect to length of remain during treatment, around 83% of new-borns remained for over 10 days. This examination has showed that weight, nearness of abnormality VACTERL, and inconveniences after medical procedure were altogether connected with result of surgery among new-borns with the conclusion of EA+TEF admitted to FMIC emergency clinic.

Conclusions: The state of EA+TEF is very predominant among new-borns in Afghanistan. Weight of new-conceived, nearness of abnormality VACETRL, and confusion were found as huge determinants of results of medical procedure for new-borns with EA+TEF. It is critical to plan mediations which could help in improving the results of medical procedure and lessen the danger of mortality among new-borns. The high rate of low birth weight, postponed determination, poor referral, and absence of cutting edge neonatological back up are significant contributory variables to poor result.