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Intraoperative management of esophageal atresia: small steps that cannot be ignored in Madagascar.

Abstract The management of esophageal atresia is still limited due to the precariousness of technical equipments in Madagascar. Our case study aims to highlight possible therapeutic options and to describe the progresses to be made so as to optimize treatment of this congenital pathology. We collected the medical records of all patients hospitalized for esophageal atresia in the Department of Surgical Reanimation at the University Hospital-JRA Antananarivo. The first patients admitted who survived for a period of 42 months (between January 2011 and June 2014) were included in the study. Among the 17 patients admitted with esophageal atresia, three full-term newborns with type III esophageal atresia, successively admitted in Surgical Reanimation, were the first patients in Madagascar to survive after surgery. Only one patient had associated malformations. These three babies were extubated early in the operating room; they underwent oxygen therapy until normal spontaneous breathing. New-born babies underwent post-operatory physical therapy allowing to improve their respiratory status. Overall mortality rate from this pathology was 76.5% in 42 months. Despite these initial success, progresses still remain to be done in the treatment of this congenital anomaly, from diagnosis up to postoperative period. The improvement of technical equipments, especially ventilation and nutritional support equipments would allow more meaningful results, like in the countries where progresses has been made in the field of reanimation.
PMID
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Authors

Mayor MeshTerms
Keywords

Esophageal atresia

Madagascar

mortality

precariousness

survival

Journal Title the pan african medical journal
Publication Year Start




PMID- 28748011
OWN - NLM
STAT- MEDLINE
DA  - 20170727
DCOM- 20170804
LR  - 20170804
IS  - 1937-8688 (Electronic)
VI  - 27
DP  - 2017
TI  - [Intraoperative management of esophageal atresia: small steps that cannot be
      ignored in Madagascar].
PG  - 9
LID - 10.11604/pamj.2017.27.9.10817 [doi]
AB  - The management of esophageal atresia is still limited due to the precariousness
      of technical equipments in Madagascar. Our case study aims to highlight possible 
      therapeutic options and to describe the progresses to be made so as to optimize
      treatment of this congenital pathology. We collected the medical records of all
      patients hospitalized for esophageal atresia in the Department of Surgical
      Reanimation at the University Hospital-JRA Antananarivo. The first patients
      admitted who survived for a period of 42 months (between January 2011 and June
      2014) were included in the study. Among the 17 patients admitted with esophageal 
      atresia, three full-term newborns with type III esophageal atresia, successively 
      admitted in Surgical Reanimation, were the first patients in Madagascar to
      survive after surgery. Only one patient had associated malformations. These three
      babies were extubated early in the operating room; they underwent oxygen therapy 
      until normal spontaneous breathing. New-born babies underwent post-operatory
      physical therapy allowing to improve their respiratory status. Overall mortality 
      rate from this pathology was 76.5% in 42 months. Despite these initial success,
      progresses still remain to be done in the treatment of this congenital anomaly,
      from diagnosis up to postoperative period. The improvement of technical
      equipments, especially ventilation and nutritional support equipments would allow
      more meaningful results, like in the countries where progresses has been made in 
      the field of reanimation.
FAU - Randriamizao, Harifetra Mamy Richard
AU  - Randriamizao HMR
AD  - Service de Reanimation Chirurgicale, CHU-HJRA BP 4150, Antananarivo, Faculte de
      Medecine d'Antananarivo, Universite d'Antananarivo, Madagascar.
FAU - Rakotondrainibe, Aurelia
AU  - Rakotondrainibe A
AD  - Service de Reanimation Chirurgicale, CHU-HJRA BP 4150, Antananarivo, Faculte de
      Medecine d'Antananarivo, Universite d'Antananarivo, Madagascar.
FAU - Rahanitriniaina, Nadia Marie Philibertine
AU  - Rahanitriniaina NMP
AD  - Service de Reanimation Chirurgicale, CHU-HJRA BP 4150, Antananarivo, Faculte de
      Medecine d'Antananarivo, Universite d'Antananarivo, Madagascar.
FAU - Rajaonera, Andriambelo Tovohery
AU  - Rajaonera AT
AD  - Service de Reanimation Chirurgicale, CHU-HJRA BP 4150, Antananarivo, Faculte de
      Medecine d'Antananarivo, Universite d'Antananarivo, Madagascar.
FAU - Andriamanarivo, Mamy Lalatiana
AU  - Andriamanarivo ML
AD  - Service de Chirurgie Viscerale Pediatrique, CHU-HJRA BP 4150, Antananarivo,
      Faculte de Medecine d'Antananarivo, Universite d'Antananarivo, Madagascar.
LA  - fre
PT  - Case Reports
PT  - Journal Article
TT  - Prise en charge peri-operatoire de l'atresie de l'oesophage: petits pas non
      negligeables a Madagascar.
DEP - 20170505
PL  - Uganda
TA  - Pan Afr Med J
JT  - The Pan African medical journal
JID - 101517926
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Aftercare
MH  - Esophageal Atresia/mortality/physiopathology/*surgery
MH  - Female
MH  - Humans
MH  - Infant, Newborn
MH  - Madagascar
MH  - Male
MH  - Oxygen/*administration & dosage
MH  - Physical Therapy Modalities
PMC - PMC5511713
OTO - NOTNLM
OT  - Esophageal atresia
OT  - Madagascar
OT  - mortality
OT  - precariousness
OT  - survival
EDAT- 2017/07/28 06:00
MHDA- 2017/08/05 06:00
CRDT- 2017/07/28 06:00
PHST- 2016/09/27 [received]
PHST- 2017/04/16 [accepted]
AID - 10.11604/pamj.2017.27.9.10817 [doi]
AID - PAMJ-27-9 [pii]
PST - epublish
SO  - Pan Afr Med J. 2017 May 5;27:9. doi: 10.11604/pamj.2017.27.9.10817. eCollection
      2017.