{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:40:27Z","timestamp":1790620827778,"version":"4.1.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Anastomotic leakage remains one of the most common complications after esophageal atresia (EA) repair. However, its impact on long-term esophageal morbidity and functional outcomes remains incompletely understood. This study evaluated the clinical consequences of postoperative anastomotic leakage following EA repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed patients with EA who underwent surgical repair at a single tertiary center between 2010 and 2024. Patients with type E EA were excluded. Clinical characteristics, operative variables, postoperative complications, feeding outcomes, and long-term esophageal morbidities were compared according to the presence of anastomotic leakage. Multivariable logistic regression analyses were performed to identify factors associated with anastomotic stricture and gastroesophageal reflux disease (GERD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 143 patients were included, of whom 36 (25.2%) developed anastomotic leakage. Patients with leakage had a higher incidence of anastomotic stricture than those without leakage (78% vs. 57%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029). Leakage was also associated with delayed feeding progression, including longer times to feeding initiation (11 vs. 8 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022), oral feeding initiation (38 vs. 14 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), achievement of full feeding (35 vs. 21 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037), and oral full feeding (58 vs. 26 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012). Unplanned reoperations were more frequent in the leakage group (31% vs. 11%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008). In multivariable analysis, greater gap distance was independently associated with an increased risk of anastomotic stricture (adjusted OR 1.38, 95% CI 1.05\u20131.87,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026), whereas anastomotic leakage remained associated with GERD after adjustment for the available covariates (adjusted OR 2.60, 95% CI 1.14\u20136.26,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Anastomotic leakage after EA repair is associated with delayed feeding progression, increased esophageal morbidity, and a higher risk of unplanned reoperation. In addition, anastomotic leakage remained associated with GERD after adjustment for the available covariates. These findings suggest that patients who experience postoperative leakage represent a high-risk group that may benefit from careful long-term surveillance and multidisciplinary follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1907146","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T05:34:41Z","timestamp":1784525681000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Long-term impact of anastomotic leakage following esophageal atresia repair: feeding outcomes, esophageal morbidity, and reinterventions"],"prefix":"10.3389","volume":"14","author":[{"given":"Suhyeon","family":"Ha","sequence":"first","affiliation":[{"name":"Division of Pediatric Surgery, Asan Medical Center Children's Hospital, Asan Medical Center, University of Ulsan College of Medicine","place":["Seoul, Republic of 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Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong Jae","family":"Kwon","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Asan Medical Center Children's Hospital, Asan Medical Center, University of Ulsan College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.prrv.2010.01.007","article-title":"Oesophageal atresia and tracheo-oesophageal fistula: current management strategies and complications","volume":"11","author":"Holland","year":"2010","journal-title":"Paediatr Respir Rev"},{"key":"B2","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/1750-1172-2-24","article-title":"Oesophageal atresia","volume":"2","author":"Spitz","year":"2007","journal-title":"Orphanet J Rare 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