Prediction And Prevention of Complications After Surgical Correction of Esophageal Atresia In Newborns

The article is devoted to an urgent problem of neonatal surgery – prognosis and prevention of complications after surgical correction of esophageal atresia in newborns. The authors present a systematic analysis of risk factors contributing to the development of postoperative complications, such as anastomosis failure, esophageal strictures, aspiration pneumonia and gastroesophageal reflux. Surgical correction of esophageal atresia remains one of the most difficult operations of neonatal surgery: even with the improvement of anastomosis techniques, early and late postoperative morbidity remains significant. The most common negative outcomes are anastomosis failure, restenosis, recurrence of tracheoesophageal fistula, aspiration-related respiratory episodes, and delayed somatic growth. The purpose of this study was to create a predictive model of complications, as well as to evaluate the effectiveness of a comprehensive preventive strategy, including modification of surgical techniques, targeted respiratory support and personalized nutritional management. The data of 215 newborns operated on in 2000-2024 at the federal center of the third level were analyzed; the median follow- up was twelve months. A multifactorial risk scale was created, confirmed by an AUC of 0.82 (95% CI 0.78–0.86), and a significant decrease in the incidence of severe complications was demonstrated when using the prevention protocol Based on a retrospective analysis of clinical observations, key clinical and instrumental markers have been identified that make it possible to predict the development of complications with high accuracy. Modern approaches and methods of preventing complications are considered, including the improvement of surgical techniques, optimization of postoperative management of patients and the use of early rehabilitation programs. The results obtained can be useful for practicing neonatology surgeons, pediatricians, and neonatal intensive care specialists to improve clinical outcomes and quality of life for young patients.