QUALITY-OF-LIFE MORE THAN 20 YEARS AFTER REPAIR OF ESOPHAGEAL ATRESIA

Purpose: To examine the quality of life after repair of esophageal atr esia, follow-up studies were performed in 58 of 71 surviving patients (81.7%). Methods: Fifty patients with primary anastomosis and all eigh t surviving patients with colon interposition were seen. The mean age was 25.3 years (range, 20 to 31). Symptoms were evaluated by a standar dized interview. Quality of life assessment was performed using a visu al analogue scale (0 to 100 points), the Spitzer Index (5 dimensions, 10 points), and the Gastrointestinal Quality of Life Index (GIQLI, 5 d imensions, 128 points). Results: After primary anastomosis the estimat ed meal capacity was unrestricted in 46 patients (92%), but numerous s ymptoms such as recidivating cough (60%), hold up (48%), and short bre ath (30%) were reported. All symptoms except cough were seen more freq uently in patients with colon interposition, and all of these patients suffered from periods of short breath. Quality of life scores were hi gher in patients with primary anastomosis compared with colon interpos ition. The difference in the visual analogue scale score did not reach statistical significance, but the mean Spitzer Index was 9.7 compared with 8.8 after colon interposition (P <.05). The GIQLI after primary anastomosis was similar to that in healthy controls and was significan tly lower in patients with colon interposition. This was because of sp ecific symptoms, which scored 49.3 after colon interposition compared with 61.7 after primary anastomsis (P<.05) and to 54.8 (SD 5) in healt hy controls (P<.05). Physical and social functions, emotions, and inco nvenience of a medical treatment scored similar in patients with prima ry anastomosis, colon interposition, and healthy volunteers. Conclusio ns: The long-term quality of life after primary anastomosis was excell ent. Patients with colon interposition suffer more frequently from var ious gastrointestinal and respiratory symptoms, but they lead an other wise normal life. Copyright (C) 1998 by W.B. Saunders Company.