Prognosis and clinical issues of esophageal atresia in extremely low birth weight neonates: a case series

Abstract Purpose Esophageal atresia (EA) in extremely low birth weight (ELBW) neonates is rare. This report aimsto clarify the clinical courses and prognosis of EA in ELBW neonates and the clinical issues of long-term survival cases. Methods A retrospective analysis was conducted for 8 neonates diagnosed with esophageal atresia. Medical records of ELBW EA neonatestreated at our institution were reviewed to assess patient demographics, clinical courses,and outcomes. Transferred patient data was obtained from their local physicians through questionnaires. Results EA in ELBW neonates were included in 8 of EA infants (7%). Complications of trisomy 18and pulmonary hypoplasia were associated with poor prognosis. During primary operations, gastrostomy and esophageal banding were performed together in 50% of the cases, while gastrostomy was performed alone in 25%. Esophageal anastomosis was not performed during any primary operation. All causes of death, except for 1 case, were due to non-surgical causes. A long-term survival case of 17 years postoperatively was included. Conclusion Most cases had a high mortality rate. Therefore, it is essential to share information about the prognosis with parents and multidisciplinary specialists and to select an appropriate treatment strategy for each case.