The value of prophylactic chest tubes in tracheoesophageal fistula repair

Purpose Intraoperative chest tubes (IOCTs) can be placed during esophageal atresia/tracheoesophageal fistula (EA/TEF) repair to control pneumothoraces and detect esophageal leaks, potentially preventing the need for postoperative chest tubes (POCTs). However, data are lacking regarding IOCTs’ effect...

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Bibliographic Details
Published in:Pediatric surgery international 2020-06, Vol.36 (6), p.687-696
Main Authors: Nguyen, Michelle V. L., Delaplain, Patrick T., Lim, Joanna C., Golden, Jamie M., Gayer, Christopher P.
Format: Article
Language:English
Subjects:
Age
Birth weight
Esophagus
Ethnicity
Fistula
Medical referrals
Medicine
Medicine & Public Health
Mortality
Original Article
Ostomy
Patients
Pediatric Surgery
Pediatrics
Surgery
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Summary:Purpose Intraoperative chest tubes (IOCTs) can be placed during esophageal atresia/tracheoesophageal fistula (EA/TEF) repair to control pneumothoraces and detect esophageal leaks, potentially preventing the need for postoperative chest tubes (POCTs). However, data are lacking regarding IOCTs’ effect. We hypothesized that IOCT placement would not reduce the risk of POCT placement and would increase hospital length of stay (LOS). Methods This was a single-center case-control study of type C EA/TEF patients repaired at a tertiary referral center between 2006 and 2017. Postoperative complications of patients who received IOCTs ( n  = 83) were compared to that of patients who did not receive IOCTs ( n  = 26). Patients were compared via propensity score matching. Additionally, sensitivity analyses excluding low birth weight (LBW) patients and patients undergoing delayed esophageal anastomosis were also performed. Results There was no significant difference in rates of pneumothoraces or esophageal leaks between the IOCT and no-IOCT groups, nor were either of these complications detected earlier in the IOCT group. Rates of POCT placement and mortality also did not differ between groups. IOCT patients were associated with increased hospital LOS (28 vs 15.5 days, p  
ISSN:0179-0358
1437-9813
DOI:10.1007/s00383-020-04664-6