PhD defence C.A. (Chantal) ten Kate

Dissertation in short:

In my thesis ‘It doesn’t end with closure: optimizing health care throughout life after esophageal atresia repair’ I have researched the complications and comorbidities that patients born with esophageal atresia can encounter throughout life. In the first part, I have studied the genetic predisposition of two conditions with a higher prevalence in patients with esophageal atresia, knowing pyloric stenosis and Barrett's esophagus. In the second part, I have discussed the management and possible interventions of a few complications and comorbidities. I have presented the study protocol for a randomized controlled trial on intralesional steroid injections to prevent refractory anastomotic strictures in the first year of life. Next, we have made recommendations to improve the health care of adults born with esophageal atresia. Due to the increased risk of Barrett's esophagus and esophageal carcinoma, these patients participate in the endoscopic surveillance program of the Erasmus MC. We have evaluated the first years of this surveillance program, and have provided recommendations to adjust the surveillance protocol. In the third part, I have studied the quality of life of this population. both in children and in adults. For this purpose, we have used existing validated questionnaires. We have also validated a new, foreign questionnaire that has been translated to Dutch, and have developed a new questionnaire of our own. Finally, I have discussed all my findings in a broader perspective, and make several recommendations for future research.