Anti-reflux medication after esophageal atresia repair: a retrospective study from a tertiary center in Saudi Arabia

Background

Esophageal atresia (EA), frequently associated with tracheoesophageal fistula (TEF), is the most common congenital anomaly of the esophagus. Although survival after surgical repair has improved substantially, gastroesophageal reflux disease (GERD) remains a frequent postoperative complication. Proton pump inhibitors (PPIs) are commonly prescribed to reduce GERD-related complications, including anastomotic stricture; however, evidence supporting their effectiveness is conflicting. This study evaluated the association between postoperative PPI use and outcomes, including esophageal stricture formation, in children undergoing EA repair at a tertiary center. Methodology: This retrospective cohort study included patients with EA managed at King Fahad Medical City, Riyadh, Saudi Arabia, between January 1, 2010, and December 30, 2021. Patients treated initially at another institution, those who died before or after repair because of unrelated comorbidities, patients with long-gap EA or complex surgical procedures, and those with type E TEF were excluded. Demographic, clinical, operative, postoperative, and follow-up data were abstracted from medical records. Categorical variables were compared using Fisher’s exact test. A two-sided p value <0.05 was considered statistically significant.