{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T09:54:04Z","timestamp":1775210044296,"version":"3.50.1"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,19]],"date-time":"2021-06-19T00:00:00Z","timestamp":1624060800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,19]],"date-time":"2021-06-19T00:00:00Z","timestamp":1624060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Oesophageal atresia is a congenital malformation of the oesophagus and a serious malformation of the digestive system, postoperative complications include acute respiratory failure, pneumonia, anastomotic fistula, anastomotic stenosis, tracheal stenosis, gastroesophageal reflux and eosinophilic oesophagitis, anastomotic fistula is one of the important causes of postoperative death. The objective of this study is to identify the risk factors for anastomotic complications after one-stage anastomosis for oesophageal atresia.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A retrospective analysis was performed on the clinical data of 107 children with congenital oesophageal atresia who underwent one-stage anastomosis in our hospital from January 2013 to December 2018. Single-factor and multivariate logistic regression analyses were performed to determine the risk factors for anastomotic fistula and anastomotic stenosis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 107 children with oesophageal atresia underwent one-stage anastomosis, and the incidence of anastomotic fistula was 26.2%. The probability of anastomotic stenosis in the long term was 52.3%, and the incidence of refractory stenosis (dilation \u22655 times) was 13.1%. Analysis of the clinical count data in the anastomotic fistula group and non-anastomotic fistula group showed that preoperative albumin (F\u2009=\u20094.199, <jats:italic>P<\/jats:italic>\u2009=\u20090.043), low birth weight (F\u2009=\u20097.668, <jats:italic>P<\/jats:italic>\u2009=\u20090.007) and long gap defects (F\u2009=\u20096.107, <jats:italic>P<\/jats:italic>\u2009=\u20090.015) were risk factors for postoperative anastomotic fistula. Further multivariate logistic regression analysis showed that low birth weight (Wald2\u2009=\u20094.499, <jats:italic>P<\/jats:italic>\u2009=\u20090.034, OR\u2009=\u20092.775) and long gap defects (Wald2\u2009=\u20096.769, <jats:italic>P<\/jats:italic>\u2009=\u20090.009, OR\u2009=\u20094.939) were independent risk factors for postoperative anastomotic fistula. Premature delivery (F\u2009=\u20095.338, <jats:italic>P<\/jats:italic>\u2009=\u20090.023), anastomotic fistula (F\u2009=\u200911.381, <jats:italic>P<\/jats:italic>\u2009=\u20090.001), endoscopic surgery (F\u2009=\u20096.343, <jats:italic>P<\/jats:italic>\u2009=\u20090.013), preoperative neutrophil count (F\u2009=\u20098.602, <jats:italic>P<\/jats:italic>\u2009=\u20090.004), preoperative low albumin (F\u2009=\u20098.410, <jats:italic>P<\/jats:italic>\u2009=\u20090.005), and a preoperative prognostic nutritional index &lt;\u200954 (F\u2009=\u20095.54, <jats:italic>P<\/jats:italic>\u2009=\u20090.02) were risk factors for refractory anastomotic stenosis in children. Further multivariate logistic regression analysis showed that postoperative anastomotic fistula (Wald2\u2009=\u200911.417, <jats:italic>P<\/jats:italic>\u2009=\u20090.001, OR\u2009=\u20098.798), endoscopic surgery (Wald2\u2009=\u20099.633, <jats:italic>P<\/jats:italic>\u2009=\u20090.002, OR\u2009=\u20094.808), and a prognostic nutritional index &lt;\u200954 (Wald2\u2009=\u20094.540, P\u2009=\u20090.002, OR\u2009=\u20092.3798) were independent risk factors for refractory anastomotic stenosis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Low birth weight and long gap defects are important predictors of postoperative anastomotic fistula, and the possibility of refractory anastomotic stenosis should be considered. The long-term risk of anastomotic stenosis was increased in children undergoing endoscopic surgery and in those with a preoperative prognostic nutritional index &lt;\u200954.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13019-021-01557-0","type":"journal-article","created":{"date-parts":[[2021,6,19]],"date-time":"2021-06-19T11:03:43Z","timestamp":1624100623000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Risk factors for anastomotic complications after one-stage anastomosis for oesophageal atresia"],"prefix":"10.1186","volume":"16","author":[{"given":"Jin-Xi","family":"Huang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Song-Ming","family":"Hong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeng-Chun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dian-Ming","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun-Jie","family":"Hong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3341-9516","authenticated-orcid":false,"given":"Chaoming","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,6,19]]},"reference":[{"issue":"3","key":"1557_CR1","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1136\/archdischild-2011-300597","volume":"97","author":"RN Pedersen","year":"2012","unstructured":"Pedersen RN, Calzolari E, Husby S, Garne E, EUROCAT Working group*. Oesophageal atresia: prevalence, prenatal diagnosis and associated anomalies in 23 European regions. Arch Dis Child. 2012;97(3):227\u201332. https:\/\/doi.org\/10.1136\/archdischild-2011-300597.","journal-title":"Arch Dis Child"},{"key":"1557_CR2","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1055\/s-0036-1597946","volume":"28","author":"B Thomas","year":"2018","unstructured":"Thomas B, Nadine Z, Vera C, et al. Esophageal atresia with or without tracheoesophageal fistula (EA\/TEF): Association of Different EA\/TEF subtypes with specific co-occurring congenital anomalies and implications for diagnostic workup. Eur J Pediatr Surg. 2018;28:176\u201382.","journal-title":"Eur J Pediatr Surg"},{"issue":"1","key":"1557_CR3","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1038\/s41572-019-0077-0","volume":"5","author":"M van Lennep","year":"2019","unstructured":"van Lennep M, Singendonk MMJ, Dall'Oglio L, et al. Oesophageal atresia. Nat Rev Dis Primers. 2019;5(1):26. https:\/\/doi.org\/10.1038\/s41572-019-0077-0.","journal-title":"Nat Rev Dis Primers"},{"key":"1557_CR4","unstructured":"R Daum. Postoperative complications following operation for oesophageal atresia and tracheo-oesophageal fistula. Progress Pediatr Surg. 1970;1(1):209."},{"key":"1557_CR5","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1055\/s-0033-1347917","volume":"23","author":"B Robert","year":"2013","unstructured":"Robert B, Jean-Martin L, Dominique L. Anastomotic stricture after esophageal atresia repair: a critical review of recent literature. Eur J Pediatr Surg. 2013;23:204\u201313.","journal-title":"Eur J Pediatr Surg"},{"key":"1557_CR6","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1016\/j.jpedsurg.2016.11.010","volume":"52","author":"R Helena","year":"2017","unstructured":"Helena R, Lucas M, Charlotte V, et al. Multicentre survey on the current surgical management of oesophageal atresia in Belgium and Luxembourg. J Pediatr Surg. 2017;52:239\u201346.","journal-title":"J Pediatr Surg"},{"issue":"24","key":"1557_CR7","first-page":"2179","volume":"45","author":"D Korenaga","year":"1998","unstructured":"Korenaga D, Toh Y, Maekawa S, Ikeda T, Sugimachi K. Intra-operative measurement of the tissue blood flow for evaluating blood supply to the gastric tube for esophageal reconstruction. Hepatogastroenterology. 1998;45(24):2179\u201380.","journal-title":"Hepatogastroenterology"},{"key":"1557_CR8","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1136\/archdischild-2012-301730","volume":"97","author":"L C\u00e9line","year":"2012","unstructured":"C\u00e9line L, Laurent M, Julia S, et al. Long-term outcome of children with oesophageal atresia type III. Arch Dis Child. 2012;97:808\u201311.","journal-title":"Arch Dis Child"},{"key":"1557_CR9","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1016\/j.jss.2019.07.060","volume":"245","author":"\u00c5 Oscar","year":"2020","unstructured":"Oscar \u00c5, Dan F, G\u00f6ran J, et al. Surface microdialysis detects ischemia after esophageal resection-an experimental animal study. J Surg Res. 2020;245:537\u201343.","journal-title":"J Surg Res"},{"issue":"2-3","key":"1557_CR10","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1007\/s003830000457","volume":"17","author":"P Lyall","year":"2001","unstructured":"Lyall P, Bao-Quan Q, Beasley S. The effect of neck flexion on oesophageal tension in the pig and its relevance to repaired oesophageal atresia. Pediatr Surg Int. 2001;17(2-3):193\u20135. https:\/\/doi.org\/10.1007\/s003830000457.","journal-title":"Pediatr Surg Int"},{"issue":"2","key":"1557_CR11","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1111\/j.1442-2050.2008.00866.x","volume":"22","author":"A Turkyilmaz","year":"2009","unstructured":"Turkyilmaz A, Eroglu A, Aydin Y, Tekinbas C, Muharrem Erol M, Karaoglanoglu N. The management of esophagogastric anastomotic leak after esophagectomy for esophageal carcinoma. Dis Esophagus. 2009;22(2):119\u201326. https:\/\/doi.org\/10.1111\/j.1442-2050.2008.00866.x.","journal-title":"Dis Esophagus"},{"key":"1557_CR12","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1111\/1759-7714.12509","volume":"8","author":"H Jinxi","year":"2017","unstructured":"Jinxi H, Yi Z, Wang C, et al. Logistic regression analysis of the risk factors of anastomotic fistula after radical resection of esophageal-cardiac cancer. Thorac Cancer. 2017;8:666\u201371.","journal-title":"Thorac Cancer"},{"key":"1557_CR13","doi-asserted-by":"publisher","unstructured":"Kudsk Kenneth A,Tolley Elizabeth A, De Witt R Chance, et al. Preoperative albumin and surgical site identify surgical risk for major postoperative complications. JPEN J Parenter Enteral Nutr, 2003, 27: 1\u20139, 1, DOI: https:\/\/doi.org\/10.1177\/014860710302700101.","DOI":"10.1177\/014860710302700101"},{"issue":"11","key":"1557_CR14","doi-asserted-by":"publisher","first-page":"2242","DOI":"10.1016\/j.jpedsurg.2019.06.017","volume":"54","author":"T Stadil","year":"2019","unstructured":"Stadil T, Koivusalo A, Svensson JF, J\u00f6nsson L, Lilja HE, Thorup JM, et al. Surgical treatment and major complications within the first year of life in newborns with long gap esophageal atresia gross type a and B - a systematic review. J Pediatr Surg. 2019;54(11):2242\u20139. https:\/\/doi.org\/10.1016\/j.jpedsurg.2019.06.017.","journal-title":"J Pediatr Surg"},{"key":"1557_CR15","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0234907","volume":"15","author":"KC Anil","year":"2020","unstructured":"Anil KC, Lal BP, Sarswoti S. Low birth weight and its associated risk factors: Health facility-based case-control study. PLoS ONE. 2020;15:e0234907.","journal-title":"PLoS ONE"},{"key":"1557_CR16","doi-asserted-by":"publisher","first-page":"e398","DOI":"10.1111\/apa.12322","volume":"102","author":"K Meredith","year":"2013","unstructured":"Meredith K, Patrick HC, Anthony RC, et al. Perfusion index in the very preterm infant. Acta Paediatr. 2013;102:e398\u2013401.","journal-title":"Acta Paediatr"},{"issue":"1","key":"1557_CR17","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1055\/s-0042-111002","volume":"49","author":"A Tringali","year":"2017","unstructured":"Tringali A, Thomson M, Dumonceau JM, Tavares M, Tabbers MM, Furlano R, et al. Pediatric gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guideline executive summary. Endoscopy. 2017;49(1):83\u201391. https:\/\/doi.org\/10.1055\/s-0042-111002.","journal-title":"Endoscopy"},{"key":"1557_CR18","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1007\/s00383-016-3931-0","volume":"32","author":"O Yuichi","year":"2016","unstructured":"Yuichi O, Kosaku M, Yuko B, et al. Evaluation of the intraoperative risk factors for esophageal anastomotic complications after primary repair of esophageal atresia with tracheoesophageal fistula. Pediatr Surg Int. 2016;32:869\u201373.","journal-title":"Pediatr Surg Int"},{"issue":"3","key":"1557_CR19","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1111\/dote.12177","volume":"28","author":"R Shah","year":"2015","unstructured":"Shah R, Varjavandi V, Krishnan U. Predictive factors for complications in children with esophageal atresia and tracheoesophageal fistula. Dis Esophagus. 2015;28(3):216\u201323. https:\/\/doi.org\/10.1111\/dote.12177.","journal-title":"Dis Esophagus"},{"key":"1557_CR20","volume":"26","author":"C Xu","year":"2020","unstructured":"Xu C, Yuanbin H, Liu C, et al. The Value of Thoracic Lavage in the Treatment of Anastomotic Leakage After Surgery for Type III Esophageal Atresia. Med Sci Monit. 2020;26:e919962.","journal-title":"Med Sci Monit"},{"key":"1557_CR21","doi-asserted-by":"crossref","unstructured":"D'Urzo C, et al., Major anastomotic dehiscence after repair of esophageal atresia: conservative management or reoperation? Dis Esophagus. 2005;18(2):120\u20133.","DOI":"10.1111\/j.1442-2050.2005.00457.x"},{"key":"1557_CR22","doi-asserted-by":"crossref","unstructured":"Godoy J, Ferraris T and Guelfand M. Early Management of Esophageal Leak in Esophageal Atresia: Changing Paradigms. J Laparoendosc Adv Surg Tech A. 2020;30(8):923\u20136.","DOI":"10.1089\/lap.2020.0099"},{"key":"1557_CR23","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1111\/ases.12714","volume":"13","author":"CN Indalecio","year":"2020","unstructured":"Indalecio CN, Bel\u00e9n AC, Jorge GL, et al. Thoracoscopic approach for complications after esophageal atresia repair: initial experience. Asian J Endosc Surg. 2020;13:147\u201351.","journal-title":"Asian J Endosc Surg"},{"key":"1557_CR24","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1136\/archdischild-2017-314710","volume":"104","author":"WT Vergouwe Floor","year":"2019","unstructured":"Vergouwe Floor WT, John V, Hanneke IJ, et al. Risk factors for refractory anastomotic strictures after oesophageal atresia repair: a multicentre study. Arch Dis Child. 2019;104:152\u20137.","journal-title":"Arch Dis Child"},{"key":"1557_CR25","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1097\/SLA.0000000000002985","volume":"271","author":"O Kazuo","year":"2020","unstructured":"Kazuo O, Yoshifumi B, Taisuke Y, et al. Prognostic nutritional index, tumor-infiltrating lymphocytes, and prognosis in patients with esophageal Cancer. Ann Surg. 2020;271:693\u2013700.","journal-title":"Ann Surg"}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-021-01557-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13019-021-01557-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-021-01557-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,19]],"date-time":"2021-06-19T11:05:09Z","timestamp":1624100709000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiothoracicsurgery.biomedcentral.com\/articles\/10.1186\/s13019-021-01557-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,19]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1557"],"URL":"https:\/\/doi.org\/10.1186\/s13019-021-01557-0","relation":{},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,19]]},"assertion":[{"value":"29 July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 June 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 June 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The hospital ethics committee approval was granted of this article. Consent for publication was obtained from the children\u2019s parents.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"176"}}