Objective The aim of this study is to characterize long-term morbidities of oesophageal atresia (OA) with or without tracheoesophageal fistula (TOF). Methods Infants born with OA/TOF from 2000 to 2016 in Western Australia were included for analysis. Infants were categorized into high-risk and low-risk groups based on the presence of one or more perioperative risk factors [low birth weight, vertebraldefects, anal atresia, cardiac defects, TOF, renalanomalies, limb abnormalities (VACTERL), anastomotic leak, long gap OA, and failure to establish oral feeds within the first month] identified by a previous Canadian study. Frequency of morbidities in infants with perioperative risk factors was compared. Results Of 102 patients, 88 (86%) had OA with distal TOF (type C). The most common morbidities in our cohort were anastomotic oesophageal strictures (AS) (n=53, 52%), tracheomalacia (n=48, 47%), gastroesophageal reflux disease (GORD) (n=42, 41%) and recurrent respiratory tract infections (n=40, 39%). Presence of GORD (30/59 vs 12/43, p=0.04) and median frequency of AS dilatations (8 vs 3, n=59, p=0.03) were greater in the high-risk group. This study further confirmed that inability to be fed orally within the first month was associated with high morbidities. Conclusions Gastrointestinal and respiratory morbidities remain high in OA/TOF regardless of perioperative risk factors. Inability to be fed orally within the first month is a predictor of poor outcomes with high frequency of gastrointestinal and respiratory comorbidities. All data relevant to the study are included in the article or uploaded as supplementary information.

中文翻译：

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气管食管瘘/食管闭锁患儿预后不良的预测因素：澳大利亚的经验

目的 本研究的目的是描述伴或不伴气管食管瘘 (TOF) 的食管闭锁 (OA) 的长期发病率。方法 纳入 2000 年至 2016 年在西澳大利亚出生的患有 OA/TOF 的婴儿进行分析。根据是否存在一种或多种围手术期危险因素 [低出生体重、椎体缺陷、肛门闭锁、心脏缺陷、TOF、肾异常、肢体异常 (VACTERL)、吻合口漏、长缺口 OA，以及未能在第一个月内建立口服喂养] 由先前的加拿大研究确定。比较了具有围手术期危险因素的婴儿的发病率。结果 102 名患者中，88 名 (86%) 患有骨关节炎伴远端 TOF（C 型）。我们队列中最常见的疾病是吻合口食管狭窄 (AS) (n=53, 52%)、气管软化症 (n=48, 47%)、胃食管反流病 (GORD) (n=42, 41%) 和复发性呼吸道疾病道感染 (n=40, 39%)。GORD 的存在（30/59 对 12/43，p=0.04）和 AS 扩张的中位频率（8 对 3，n=59，p=0.03）在高风险组中更高。该研究进一步证实，在第一个月内无法口服喂养与高发病率有关。结论 无论围手术期危险因素如何，OA/TOF 患者的胃肠道和呼吸系统疾病发病率仍然很高。无法在第一个月内进行口服喂养是胃肠道和呼吸系统合并症发生频率高的不良结果的预测指标。