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International Journal of Surgery Science
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Vol. 7, Issue 1, Part B (2023)

Primary esophageal anastomotic using mattress suturing technique in cases of esophageal atresia with fistula

Author(s): Leecarlo Millano, Indira Fadhila and Melian Anita
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.
Pages: 88-91  |  176 Views  96 Downloads
How to cite this article:
Leecarlo Millano, Indira Fadhila, Melian Anita. Primary esophageal anastomotic using mattress suturing technique in cases of esophageal atresia with fistula. Int J Surg Sci 2023;7(1):88-91. DOI:
International Journal of Surgery Science
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