Impact of serial clinical swallow evaluations and feeding interventions on growth and feeding outcomes in children with long‑gap esophageal atresia after anastomosis:a retrospective cohort study  

作　　者：Jun-Li Wang Run-Qi Huang Chun-Yan Tang Wen-Jie Wu Fei Li Tai Ren Jun Wang Wei-Hua Pan 

机构地区：[1]Developmental and Behavioral Pediatric Department,Xinhua Hospital Afliated to Shanghai Jiao Tong University School of Medicine,1665 Kongjiang Road,Shanghai 200092,China [2]Child Primary Care Department&Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health,Xinhua Hospital Afliated to Shanghai Jiao Tong University School of Medicine,1665 Kongjiang Road,Shanghai 200092,China [3]Department of Pediatric Surgery,Xinhua Hospital Afliated to Shanghai Jiao Tong University School of Medicine,1665 Kongjiang Road,Shanghai 200092,China

出　　处：《World Journal of Pediatrics》2024年第12期1293-1305,共13页世界儿科杂志(英文版)

基　　金：supported by grants from the National Natural Science Foundation of China(82125032,81930095,81761128035,and 82204048);the Science and Technology Commission of Shanghai Municipality(23Y21900500,19410713500 and 2018SHZDZX01);the Shanghai Municipal Commission of Health and Family Planning(GWV-11.1-34,2020CXJQ01,2018YJRC03);the Shanghai Clinical Key Subject Construction Project(shslczdzk02902);Innovative research team of high-level local universities in Shanghai(SHSMUZDCX20211100);the Guangdong Key Project(2018B030335001);The Shanghai three-year action plan for strengthening the construction of the public health system(GWVI-11.1-34);Ministry of Science and Technology Innovation 2030-Major Project of"Brain Science and Brain like Research"(2021ZD0200800);Shanghai Hospital Development Center(No.16CR3117B).

摘　　要：Background Children undergoing surgical anastomosis for long-gap esophageal atresia(LGEA)often sufer from complications related to delayed oral feeding,which may impair their early development.Clinical swallow evaluation(CSE)is an efective technique to improve feeding outcomes.However,there are limited evidences on the application of CSE in these children.Methods Since 2020,serial CSEs have been consistently implemented for children undergoing anastomosis for LGEA in our hospital.We conducted a retrospective study comparing 19 children who received CSE with 31 historical controls who did not.Inverse probability of treatment weighting(IPTW)was applied to balance preoperative characteristics.We compared the time from surgery to full oral feeding and the rate of postoperative complications between the two groups.Growth curves for length-for-age Z score(LAZ)and weight-for-age Z score(WAZ)up to age 3 were ftted using generalized additive mixed models.Results The median time to full oral feeding was 1.1 months[interquartile range(IQR),0.8–2.4]in the CSE group and 1.5 months(IQR,0.6–5.7)for controls.After IPTW,CSE was associated with a shorter time to full oral feeding,with a weighted hazard ratio of 2.26[95%confdence interval(CI),1.21 to 4.24].LAZ growth curves signifcantly difered between groups(P=0.001).Conclusion CSE was associated with the expedited achievement of full oral feeding and a more favorable growth pattern before 3 years of age.

关 键 词：Clinical swallow evaluation Feeding disorder Long-gap esophageal atresia Nutritional status 

分 类 号：Q95[生物学—动物学]