Evaluation of mid- and long-term quality of life in patients operated on for esophageal atresia

Abstract

Background. This study aimed to evaluate general and condition-specific quality of life in esophageal atresia (EA) patients, identifying risk factors such as associated anomalies and chronic diseases, as well as examining their impact on life quality. Methods. Patients operated on for EA between 2004 and 2020 comprised the study population. Pediatric Quality of Life (PedsQOL 4.0) and the Esophageal Atresia Quality of Life (EA-QOL) questionnaires were administered to parents of 2-7 year old children as well as both patients aged 8-17 year and their parents. Results of the PedsQOL 4.0 scale were compared with 43 healthy children. Results. The study included 66 patients (40 aged 2-7 years, 26 aged 8-17 years), with 45.5% females and 54.5% males. The mean age was 7 +/- 4.4 years. Quality of life measured by EA-QOL and PedsQOL 4.0 questionnaires showed no significant differences based on patient sex, gestational age or having an anastomotic stricture. In the 8-17 age group, EA patients demonstrated significantly higher emotional scale quality of life than the healthy group (p=0.001) according to parent and child PedsQOL 4.0 questionnaire scores. Conclusions. The better emotional functioning in the 8-17 age group supports their enhanced anxiety management. Sex, gestational age, or presence of an anastomotic stricture did not impact quality of life. While differences existed between patient age groups in the questionnaires administered, factors like anatomical EA type, repair mode, low birth weight, tracheomalacia, frequent lung infections, presence of associated vertebral, anorectal, cardiac, renal, limb anomalies and/or hydrocephalus (VACTERL-H), gastrostomy placement, and surgical interventions other than EA significantly influenced patients' quality of life. These findings may guide implementing measures to enhance quality of life in EA patients.