Skip to main content
NCBI home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1999 Nov;81(5):404–408. doi: 10.1136/adc.81.5.404

Respiratory function in childhood following repair of oesophageal atresia and tracheoesophageal fistula

L Agrawal 1, C Beardsmore 1, U MacFadyen 1
PMCID: PMC1718113  PMID: 10519713

Abstract

AIM—To determine the relation between respiratory function in infancy and at school age in children who have undergone oesophageal atresia and tracheoesophageal fistula repair, and assess the value of infant respiratory function testing; and to examine the effect of bronchodilators.
METHOD—Fourteen children (6 girls, and 8 boys) who had undergone respiratory function testing in infancy were retested at school age (7−12 years). Measurements included lung volume, airways resistance, peak flow, and spirometry. Clinical problems were investigated by questionnaire. Twelve children had repeat measurements after taking salbutamol.
RESULTS—Predominant complaints were non-productive cough and dysphagia, but even those children with major problems in infancy reported few restrictions at school or in sport or social activities. Respiratory function and clinical findings at school age appeared unrelated to status in infancy, such that even the patients with severe tracheomalacia requiring aortopexy did not have lung function testing suggestive of malacia at school age. Most patients showed a restrictive pattern of lung volume which would appear to result from reduced lung growth after surgery rather than being a concomitant feature of the primary congenital abnormality. Although six children reported wheeze and four had a diagnosis of asthma, only one responded to salbutamol. This suggests that a tendency to attribute all lower respiratory symptoms to asthma may have led to an overdiagnosis of this condition in this patient group.
CONCLUSION—Respiratory function testing in infancy is of limited value in medium term prognosis, but may aid management of contemporary clinical signs. In children respiratory function testing is valuable in assessing suspected asthma and effects of bronchodilators.



Full Text

The Full Text of this article is available as a PDF (87.5 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Beardsmore C. S. Lung function from infancy to school age in cystic fibrosis. Arch Dis Child. 1995 Dec;73(6):519–523. doi: 10.1136/adc.73.6.519. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Beardsmore C. S., MacFadyen U. M., Johnstone M. S., Williams A., Simpson H. Clinical findings and respiratory function in infants following repair of oesophageal atresia and tracheo-oesophageal fistula. Eur Respir J. 1994 Jun;7(6):1039–1047. [PubMed] [Google Scholar]
  3. Benjamin B., Cohen D., Glasson M. Tracheomalacia in association with congenital tracheoesophageal fistula. Surgery. 1976 May;79(5):504–508. [PubMed] [Google Scholar]
  4. Biller J. A., Allen J. L., Schuster S. R., Treves S. T., Winter H. S. Long-term evaluation of esophageal and pulmonary function in patients with repaired esophageal atresia and tracheoesophageal fistula. Dig Dis Sci. 1987 Sep;32(9):985–990. doi: 10.1007/BF01297188. [DOI] [PubMed] [Google Scholar]
  5. Blair G. K., Cohen R., Filler R. M. Treatment of tracheomalacia: eight years' experience. J Pediatr Surg. 1986 Sep;21(9):781–785. doi: 10.1016/s0022-3468(86)80366-9. [DOI] [PubMed] [Google Scholar]
  6. Chan K. N., Wong Y. C., Silverman M. Relationship between infant lung mechanics and childhood lung function in children of very low birthweight. Pediatr Pulmonol. 1990;8(2):74–81. doi: 10.1002/ppul.1950080204. [DOI] [PubMed] [Google Scholar]
  7. Chetcuti P., Myers N. A., Phelan P. D., Beasley S. W. Adults who survived repair of congenital oesophageal atresia and tracheo-oesophageal fistula. BMJ. 1988 Jul 30;297(6644):344–346. doi: 10.1136/bmj.297.6644.344. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Chetcuti P., Phelan P. D., Greenwood R. Lung function abnormalities in repaired oesophageal atresia and tracheo-oesophageal fistula. Thorax. 1992 Dec;47(12):1030–1034. doi: 10.1136/thx.47.12.1030. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Chetcuti P., Phelan P. D. Respiratory morbidity after repair of oesophageal atresia and tracheo-oesophageal fistula. Arch Dis Child. 1993 Feb;68(2):167–170. doi: 10.1136/adc.68.2.167. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Cogswell J. J., Hull D., Milner A. D., Norman A. P., Taylor B. Lung function in childhood. III. Measurement of airflow resistance in healthy children. Br J Dis Chest. 1975 Jul;69:177–187. doi: 10.1016/0007-0971(75)90077-7. [DOI] [PubMed] [Google Scholar]
  11. Couriel J. M., Hibbert M., Olinsky A., Phelan P. D. Long term pulmonary consequences of oesophageal atresia with tracheo-oesophageal fistula. Acta Paediatr Scand. 1982 Nov;71(6):973–978. doi: 10.1111/j.1651-2227.1982.tb09559.x. [DOI] [PubMed] [Google Scholar]
  12. Dudley N. E., Phelan P. D. Respiratory complications in long-term survivors of oesophageal atresia. Arch Dis Child. 1976 Apr;51(4):279–282. doi: 10.1136/adc.51.4.279. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Engum S. A., Grosfeld J. L., West K. W., Rescorla F. J., Scherer L. R., 3rd Analysis of morbidity and mortality in 227 cases of esophageal atresia and/or tracheoesophageal fistula over two decades. Arch Surg. 1995 May;130(5):502–509. doi: 10.1001/archsurg.1995.01430050052008. [DOI] [PubMed] [Google Scholar]
  14. Hampton F., Beardsmore C. S., Morgan W., Williams A., Taussig L., Thompson J. R. A scoring system for lung function tests in infants. Pediatr Pulmonol. 1992 Nov;14(3):149–155. doi: 10.1002/ppul.1950140303. [DOI] [PubMed] [Google Scholar]
  15. Malone P. S., Kiely E. M. Role of aortopexy in the management of primary tracheomalacia and tracheobronchomalacia. Arch Dis Child. 1990 Apr;65(4):438–440. doi: 10.1136/adc.65.4.438. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Milligan D. W., Levison H. Lung function in children following repair of tracheoesophageal fistula. J Pediatr. 1979 Jul;95(1):24–27. doi: 10.1016/s0022-3476(79)80076-1. [DOI] [PubMed] [Google Scholar]
  17. Robertson D. F., Mobaireek K., Davis G. M., Coates A. L. Late pulmonary function following repair of tracheoesophageal fistula or esophageal atresia. Pediatr Pulmonol. 1995 Jul;20(1):21–26. doi: 10.1002/ppul.1950200105. [DOI] [PubMed] [Google Scholar]
  18. Solymar L., Aronsson P. H., Bake B., Bjure J. Nitrogen single breath test, flow-volume curves and spirometry in healthy children, 7-18 years of age. Eur J Respir Dis. 1980 Oct;61(5):275–286. [PubMed] [Google Scholar]
  19. Wailoo M. P., Emery J. L. The trachea in children with tracheo-oesophageal fistula. Histopathology. 1979 Jul;3(4):329–338. doi: 10.1111/j.1365-2559.1979.tb03014.x. [DOI] [PubMed] [Google Scholar]
  20. Zapletal A., Paul T., Samanek M. Pulmonary elasticity in children and adolescents. J Appl Physiol. 1976 Jun;40(6):953–961. doi: 10.1152/jappl.1976.40.6.953. [DOI] [PubMed] [Google Scholar]
  21. Zapletal A., Paul T., Samánek M. Die Bedeutung heutiger Methoden der Lungenfunktionsdiagnostik zur Feststellung einer Obstruktion der Atemwege bei Kindern und Jugendlichen. Z Erkr Atmungsorgane. 1977 Aug;149(3):343–371. [PubMed] [Google Scholar]
  22. Zapletal A., Samanek M., Paul T. Upstream and total airway conductance in children and adolescents. Bull Eur Physiopathol Respir. 1982 Jan-Feb;18(1):31–37. [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES