Research Article: Disease-specific quality of life after thoracoscopic repair of esophageal atresia: a single-centre cross-sectional study
Abstract:
Survival after esophageal atresia (EA) repair now exceeds 90%, yet little is known about long-term quality of life in patients treated with thoracoscopy as the primary intended approach. Most published cohorts mix open and thoracoscopic approaches, making it difficult to disentangle disease-related impairment from approach-related morbidity. We set out to describe disease-specific health-related quality of life (HRQoL) in a cohort managed by thoracoscopy as the primary intended approach, compare our data with European reference values, and explore child–parent agreement.
Cross-sectional survey of 25 respondents (response rate 56%) from 51 children who underwent EA repair with thoracoscopy as the intended primary approach [7 (14%) required intraoperative conversion to open thoracotomy and were retained under an intention-to-treat principle] at a single Polish centre (2006–2025). The validated Polish EA-QOL questionnaire was administered: parent proxy for children aged 2–7 years ( n =?12), child self-report and parent proxy for those aged 8–17 years ( n =?13 and n =?12, respectively). Agreement between child and parent reports was evaluated with Pearson and Spearman correlations and Bland–Altman analysis. Scores were compared with published Swedish–German reference data, and clinical associations were examined using non-parametric methods.
Overall QoL% ranged from 76% to 79% across age groups. Eating difficulties were the most impaired domain in every questionnaire version (QoL%: 63%–70%), driven largely by problems with food consistency. No domain score differed from reference data after Bonferroni correction, though the Body and Scar domain in older children showed a borderline signal ( p =?0.049, Cohen's d =?0.56). Child–parent agreement was strong (Pearson r =?0.83, Bland–Altman bias 0.000, 95% limits of agreement: ?0.62 to +0.62). None of the clinical variables tested were associated with HRQoL in bivariate analyses, though the study was not powered for such comparisons.
In this single-centre cohort managed by thoracoscopy as the primary intended approach, disease-specific HRQoL was generally preserved, with eating-related difficulties as the dominant area of residual impairment. These findings add to the limited literature on approach-specific outcomes in EA and support routine long-term monitoring of food texture tolerance and reflux burden.
Introduction:
Survival after esophageal atresia (EA) repair now exceeds 90%, yet little is known about long-term quality of life in patients treated with thoracoscopy as the primary intended approach. Most published cohorts mix open and thoracoscopic approaches, making it difficult to disentangle disease-related impairment from approach-related morbidity. We set out to describe disease-specific health-related quality of life (HRQoL) in a cohort managed by thoracoscopy as the primary intended approach, compare our data with…
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