Yulia Gendler RN PhD, Emmanuelle Seguier-Lipszyc MD, Ari Silbermintz MD, Moshe Hain MD, Yoram Stern MD, Dragan Kravarusic MD, Keren Politi MD, Gabriel Amir MD PhD, Jacob Katz MD, Yelena Zeitlin MD, Sylvia Grozovski MD, Yifat Nitzan SLP, Yuliana Eshel MHA, Adi Shimoni OTR, Yifat Fischer DVM, Dana Serfaty MSc, Tami Shnayderman BPT, Kian Assi BSW, Lior Barbash MBA, and Patrick Stafler MD
Background: Aerodigestive clinics are run by interdisciplinary medical and surgical teams, and provide complex care coordination and combined endoscopies.
Objectives: To describe the design and patient population of the first pediatric aerodigestive center in Israel.
Methods: A retrospective single-center cohort study was conducted describing patients followed in the aerodigestive clinic of Schneider Children’s Medical Center of Israel, a tertiary pediatric hospital, between its inception in January 2017 and June 2020.
Results: During the study period, 100 patients were seen at the combined respiratory and digestive (NoAM) clinic, with a total of 271 visits. Median age at first assessment was 29.5 months (range 3–216). Fifty-six patients (56%) had esophageal atresia and tracheoesophageal fistula. Thirty-nine patients had an identified genetic disorder, 28 had a primary airway abnormality, 28 were oxygen dependent, and 21 were born premature. Fifty-two patients underwent triple endoscopy, consisting of flexible bronchoscopy, rigid bronchoscopy, and gastroscopy. In 33 patients, esophageal dilatation was necessary. Six patients underwent posterior tracheopexy at a median of 6 months of age (range 5 days to 8 years) all with ensuing symptom improvement. The total mean parental satisfaction score on a Likert-type scale of 1–5 (5 = highest satisfaction) was 4.5.
Conclusions: A coordinated approach is required to provide effective care to the growing population of children with aerodigestive disorders. The cross fertilization between multiple disciplines offers a unique opportunity to develop high quality and innovative care. Outcome measures must be defined to objectively measure clinical benefit.