Nutrition delivery and growth outcomes in infants with long-gap esophageal atresia who undergo the Foker process

• Published in: Journal of pediatric surgery 2021-12, Vol.56 (12), p.2133-2139
• Main Authors: Harrington, Amanda W., Riebold, Jane, Hernandez, Kayla, Staffa, Steven J., Svetanoff, Wendy Jo, Zurakowski, David, Hamilton, Thomas, Jennings, Russell, Mehta, Nilesh M., Zendejas, Benjamin
• Format: Article
• Language: English
• Subjects: Esophageal atresia; Foker process; Growth; Nutrition
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2021.07.014

•Esophageal atresia (EA) patients now survive well into adulthood.•There is a perception that EA patients are below average in weight-for-age z score (WAZ; 0=average weight for age).•There are no studies on growth in the long-gap EA (LGEA) population, specifically.•Most patients who undergo the Foker Process (FP) for LGEA have weight for age that is below average throughout infancy.•LGEA-FP infants who present with malnutrition can still achieve adequate growth despite complicated hospital courses. Predictors of growth outcomes in patients with long-gap esophageal atresia (LGEA) are not known. We examined nutrition and growth in-hospital and post-discharge in LGEA patients who underwent the Foker Process (FP). Single-center, retrospective cohort study of infants with LGEA undergoing primary (non-rescue) FP from 2014 to 2020. Weight-for-age z scores (WAZ, 0 = average), macronutrient prescription, anthropometry, and clinical variables were collected. Longitudinal median regression evaluated differences in WAZ over time. Multivariable median regression examined variables associated with change in WAZ at 1 year. 45 patients met criteria, with median (IQR) age at repair of 4 (2, 5.8) months and WAZ of -0.96 (-1.55, -0.40). On admission, 11% were moderately (WAZ