Management of Oesophageal Atresia in a Developing Country like Ghana
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2013-12-09
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Abstract
The management of Oesophageal atresia has improved in most modern centres with survival figures rising from 50% in the 1950s to over 90% in the modern era. Factors that have contributed to this improvement include antenatal diagnosis, improvement in the anaesthetic management of neonates with improved intensive care and better management of associated anomalies. In developing countries, antenatal diagnosis of Oesophageal atresia remains rare and late presentation is the norm. With the absence of neonatal ventilators postoperative care is more challenging. The Waterston classification system which recognized the contribution of factors such as Pneumonia, low birth weight below 2.5 kilograms and Congenital anomalies to prognosis remains relevant in developing countries while the Spitz classification has become more relevant in prognostication in developed countries where survival in children weighing more than 1.5 kg and without a severe cardiac anomaly is high.