Graft dilatation and Barrett’s esophagus in adults after gastric pull-up and jejunal interposition for long-gap esophageal atresia

Table 1 Patient characteristics gastric pull-up & jejunal interposition

Value	GPU (n = 9)	JI (n = 11)	P value
Male	9 (100%)	5 (46%)	0.01a
Gestational age (wk)	33.9 (29-39)	34.7 (32.3-41.3)	0.15
Premature	7 (78%)	8 (73%)	1.0
Birthweight (grams)	1680 (1030-3040)	2010 (1115-3755)	0.49
Gross type EA			0.63
A	5 (56%)	4 (36%)
B	3 (33%)	6 (55%)
C	1 (11%)	1 (9%)
Associated anomalies1	9 (100%)	6 (55%)	0.04a
Down syndrome	1 (11%)	1 (9%)
Anorectal malformations	1 (11%)	1 (9%)
Duodenal atresia	1 (11%)	1 (9%)
Musculoskeletal	4 (44%)	3 (27%)
Cardiac	1 (11%)	2 (18%)
Renal anomaly	4 (44%)	1 (9%)
Palatoschisis	2 (22%)	0

¹Some patients have multiple anomalies.

^aIndicating statistical significance.

All data are presented as median (range) or n (%). GPU: Gastric pull-up; JI: Jejunal interposition; EA: Esophageal atresia.

Table 2 Gastrointestinal outcome in gastric pull-up & jejunal interposition

Variable	GPU (n = 9)	JI (n = 11)	P value
Age at surgery (d)	128 (1-323)	67 (41-149)	0.21
Gastrostomy	8 (89%)	11 (100%)	0.45
Fundoplication	0	1 (9.1%)	1.0
Stenosis1	5 (56%)	8 (73%)	0.64
Dilatations total (n)	3 (1-4)	3 (1-15)	0.76
Dilatations within 1st yr (n)	1 (1-3)	2.5 (0-15)	0.26

¹Stenosis requiring intervention

Data are presented as median (range) or n (%). GPU: Gastric pull-up; JI: Jejunal interposition.

Table 3 Clinical data

Variable	GPU (n = 9)	JI (n = 11)	P value
Age at follow-up (median, yr)	21.5 (20.2-34.1)	24.4 (16.1-31.2)	0.85
GER complaints	6 (67%)	4 (36%)	0.37
Dysphagia	2 (22%)	7 (64%)	0.09
FOIS
Total oral diet with no restrictions	5	5
Specific food limitations	1	2
Multiple consistencies, requiring special preparation	1	0
Tube-dependent	1	0
Missing	1	4
PPI use	4 (44%)	3 (27%)	0.38
BMI (kg/m2)	19.5 (17.5-21.6)	20.9 (17.9-27.6)	0.08

Data are presented as median (range) or n (%). GPU: Gastric pull-up; JI: Jejunal interposition; GER: Gastroesophageal reflux; FOIS: Functional Oral Intake Scale; PPI: Protein-protein interaction; BMI: Body mass index.

Table 4 Radiologic, endoscopic and histologic data

Variable	GPU (n = 9)	JI (n = 11)	P value
Barium contrast results	n = 5	n = 11
Stasis	3 (60%)	10 (91%)	0.14
Stricture	0	0	-
Dilated JI graft	N/A		N/A
Mild		4 (36%)
Severe		2 (18%)
Lengthening of JI graft	N/A	4 (36%)	N/A
Endoscopy results	n = 9	n = 11
Length proximal esophagus (cm)	20 (17-24)	21 (18-25)	-
Length jejunal graft (cm)	N/A	15 (12-22)	-
Length distal esophagus (cm)	N/A	4.5 (0-8)	-
Macroscopic anomalies	5 (56%)	5 (45%)	1.0
Macroscopic esophagitis1
Grade A	0	1 (9%)	-
Grade B	0	1 (9%)	-
Columnar-lined esophagus	3 (33%)	0	0.07
Histology results	n = 8	n = 7
Normal mucosa	1 (13%)	3 (43%)	0.58
Inflammation	2 (25%)	1 (14%)	1
Intestinal metaplasia	2 (25%)	0	0.47
Other	3 (38%)	3 (43%)	1.0

¹According to the Los Angeles classification.

Data are presented as median (range) or n (%). GPU: Gastric pull-up; JI: Jejunal interposition; N/A: Not applicable.