Abstract: Background: Esophageal atresia (EA) is a common congenital malformation occurring in
approximately 1 in 2500−3000 lives births. Developed countries have survival
rates of 90% for newborns with esophageal atresia, whereas developing countries
have a much lower percentage. We report the suturing technique in EA on the
mortality outcomes from newborns with EA in Tarakan General Hospital, Jakarta,
Indonesia. The study was to investigate two different suturing techniques to
identify the advantages and disadvantages for esophageal atresia patients who
underwent primary esophageal anastomosis based on clinical manifestations and
early complications post operation.
Method: From 2016 to 2022, we
collected 25 research samples from Tarakan General Hospital in the form of
newborns with esophageal atresia. The study was analyzed using descriptive and
analytical statistics.
Result: A total of 25 EA
cases were included in the study, and all underwent primary esophageal
anastomosis. In Tarakan General Hospital, the average age of patients with esophageal
atresia underwent thoracotomy was 18.28±5.77 days. There were 14 females (56%)
and 11 males (44%), respectively, among the newborns with EA. The most common
type of EA was EA with distal tracheoesophageal fistula (TEF) or EA type C,
which had 23 cases (92%) while Waterston B had 16 cases (64%). Mattress suture
was used in 11 patients (44%), whereas simple suture was used in the remaining
patients. Sepsis and leakage occurred among 14 (56%) and 5 (20%) patients,
respectively. As shown by bivariate analysis, sepsis is substantially
associated with mortality (p<.05), while the occurrence of
anastomotic leakage was significantly lower in mattrass suture than simple
suture (p<.05). Sepsis incidence
significantly lower in mattrass suture (27.3%, 3/11 patients) compared to
simple suture (78.6%, 11/14 patients) (OR: 9.78, 95% CI: 1.55-61.64, p<.05).
There were no prognostic factors associated with the mortality of newborns with
EA in a multivariate analysis of mortality outcome.
Conclusion: Mattrass suture is significantly associated with a lower incidence
of anastomotic leakage and sepsis. At Tarakan General Hospital, neonatal
mortality with esophageal atresia was high, and sepsis was the most common
cause of mortality. An esophageal anastomosis leak and suture type are two
additional factors of mortality.
