Assessment of the type and frequency of long-term postoperative complications in neonates undergoing corrective surgery for esophageal atresia

Document Type : Research Paper

Authors

1 Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Medical Sciences Education Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

4 Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Department of Pediatric Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Introduction: Esophageal atresia (EA) and tracheoesophageal fistula (TEF) are common congenital anomalies that require urgent surgical intervention. Despite major advances in neonatal surgery, affected patients continue to experience long-term complications such as dysphagia and anastomotic stricture. This study, to our one of the first time in Eastern Iran, investigates the clinical outcomes and long-term complications of these patients in the largest pediatric surgery centers there.
Methods: This cross-sectional study included 88 neonates with EA who underwent surgical repair. Clinical data—including demographics, number of operations, postoperative complications, and long-term outcomes—were collected and analyzed. Information was obtained through caregiver interviews and review of patients’ medical records, and subsequently evaluated using appropriate statistical methods.
Results: In this study 7% of patients received a bougie after surgery. A history of hospital readmissions by the age of two years was reported in 71.6% of patients, with pneumonia (51.1%) and aspiration (35.2%) being the most common causes of hospitalization. examination of systemic symptoms showed that 27.3% of patients had cardiac symptoms, 13.6% had gastrointestinal symptoms, and 6.8% had a history of hydrocephalus or shunt placement, while 51.1% did not have these symptoms.
Conclusion: Neonates with EA/TEF face substantial postoperative morbidity, including dysphagia, anastomotic stricture, and pneumonia. Long-term follow-up and multidisciplinary management are essential to mitigate late complications and improve quality of life. Timely interventions—such as endoscopic dilation—may help optimize outcomes.

Keywords

References

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Medical Journal of Mashhad university of Medical Sciences
Volume 68, Issue 5
November and December 2025
Pages 1330-1338

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