Eur J Pediatr Surg 2017; 27(02): 192-195
DOI: 10.1055/s-0036-1584179
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Prolonged Use of Proton Pump Inhibitors as Stricture Prophylaxis in Infants with Reconstructed Esophageal Atresia

Pernilla Stenström
1   Department of Pediatric Surgery, Skane University Hospital, Lund, Sweden
2   Institution for Clinical Research, Lund University, Lund, Sweden
,
Magnus Anderberg
1   Department of Pediatric Surgery, Skane University Hospital, Lund, Sweden
2   Institution for Clinical Research, Lund University, Lund, Sweden
,
Anna Börjesson
1   Department of Pediatric Surgery, Skane University Hospital, Lund, Sweden
2   Institution for Clinical Research, Lund University, Lund, Sweden
,
Einar Arnbjornsson
1   Department of Pediatric Surgery, Skane University Hospital, Lund, Sweden
2   Institution for Clinical Research, Lund University, Lund, Sweden
› Author Affiliations
Further Information

Publication History

03 February 2016

05 April 2016

Publication Date:
23 May 2016 (online)

Abstract

Introduction Proton pump inhibitors (PPIs) are used as prophylaxis, guarding against anastomotic stricture (AS) in the aftermath of reconstructed esophageal atresia (EA). The incidence of stricture formation was studied in this setting, comparing outcomes of 3- and 12-month PPI prophylactic regimens.

Patients and Methods Patient characteristics (gestational age, birth weight, prevalence of chromosomal aberrations, and other malformations), as well as rates of survival, AS formation, and required balloon dilation, were recorded in the following therapeutic subsets: (1) all infants undergoing primary surgical anastomosis for EA in years 2010–2014 and given postoperative PPI prophylaxis for 12 months and (2) all infants similarly treated for EA in years 2001–2009 but given postoperative PPI prophylaxis for 3 months only. Duration of follow-up was 1 year in each group.

Results Patient characteristics and survival rates in 12-month (n = 33) and in 3-month (n = 30) treatment groups did not differ significantly. The prevalence of AS was 42%/43% in each group (12 months, 14/33; 3 months, 13/30; p = 1). Median number of dilations required was 3 (range, 1–9) per patient in each group (p = 0.69). Median age at initial dilation was 163 days and 63 days in 12- and 3-month groups, respectively (p = 0.04).

Conclusion Development of AS in the first year after reconstruction of EA was not reduced by prolonged PPI prophylaxis (12 vs. 3 months), but initial balloon dilation procedures were performed later in infants who were treated longer.

 
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