DELAYED ESOPHAGO-ESOPHAGEAL ANASTOMOSIS IN ESOPHAGEAL ATRESIA

Cover Page


Cite item

Full Text

Abstract

Purpose of the study: to estimate the efficacy of treatment and remote results of delayed esophago-esophageal anastomosis in children with EA.

Material and methods. We analyzed 18 case histories of children with delayed esophago-esophageal anastomosis performed at N. F. Filatov Children’s Municipal Clinical Hospital No. 13 from 2006 to 2016.

Results. Postoperative complications occurred in 16 children out of 18 (88.9%). Esophageal anastomotic leakage was developed in 4 patients (22.2%), anastomotic stenosis in 11 patients (61.1%) and gastroesophageal reflux in 14 children (77.8%). Lethality amounted to 16.7% (3 children) in the early postoperative period. As per the analysis of delayed results, dysphagia was noted in 92.3% of children. After delayed anastomosis 9 children underwent recurrent surgery, 4 of them had subsequent esophageal extirpation.

Conclusions. Considering the high rate of complications (88.9%) and bad delayed results, our observations do not allow us to recommend the delayed esophago-esophageal anastomosis as the surgery of choice for children with EA. 

About the authors

A. Yu. Razumovsky

Pirogov Russian National Research Medical University of the Ministry of Health of Russia

Email: fake@neicon.ru

Доктор медицинских наук, проф., зав. каф. детской хирургии

главный детский хирург Департамента здравоохранения г. Москвы, Президент Российской ассоциации детских хирургов

Russian Federation

A. B. Alkhasov

Pirogov Russian National Research Medical University of the Ministry of Health of Russia

Email: fake@neicon.ru
Доктор медицинских наук, проф. каф. детской хирургии Russian Federation

O. G. Mokrushina

Pirogov Russian National Research Medical University of the Ministry of Health of Russia

Email: fake@neicon.ru
Доктор медицинских наук, проф. каф. детской хирургии Russian Federation

N. V. Kulikova

N. F. Filatov Children’s Municipal Clinical Hospital No. 3, Moscow

Email: fake@neicon.ru
Врач-детский хирург Russian Federation

S. A. Gebekova

Pirogov Russian National Research Medical University of the Ministry of Health of Russia

Author for correspondence.
Email: safffrat@mail.ru
Аспирант каф. детской хирургии Russian Federation

References

  1. Пури П., Гольварт М. Атрезия пищевода // В кн.: Атлас детской оперативной хирургии. Москва: МЕДпресс-информ, 2009. С. 43–62. Puri P., Gol’vart M. Esophageal atresia// In.: Atlas detskojoperativnojhirurgii. Moskva: MED press-inform, 2009.pp. 43–62. (in Russian)
  2. Aminde L. N., Ebenye V. N., Arrey W. T., Takah N. F., Awungafac G. Oesophageal atresia with trachea-oesophageal fistula in a preterm neonate in Limbe, Cameroon: case report and brief literature review // BMC Res Notes, No. 7 (7), 2014. P. 692.
  3. Garcia A. V., Thirumoorthi A. S., Traina J. M., Schlossberg P., Sheynzon V., Kandel J. J. Image-guided esophageal anastomosis in esophageal atresia // J. Pediatr. Surg, Vol. 47. No. 10, 2012. pp. 1959–1961.
  4. Красовская Т. В., Кучеров Ю. И., Батаев Х. М., Толстов К. Н., Мокрушина О. Г. Хирургическая тактика при раз- личных формах атрезии пищевода // Детская хирургия, №5, 2000. С. 46–50. Krasovskaja T.V., Kucherov Ju.I., Bataev H.M., Tolstov K.N., Mokrushina O.G. Surgical tacticsin various forms ofesophageal atresia//Detskajahirurgija, №5, 2000. pp. 46–50. (in Russian)
  5. Ito K., Ashizuka S., Kurobe M., Ohashi S., Kuwashima N., Yoshizawa J., Ohki T. Delayed primary reconstruction of esophageal atresia and distal tracheoesophageal fistula in a 471 g infant // Int. J. Surg. Case Rep, No. 4 (2), 2013, pp. 167– 169.
  6. Lee H. Q., Hawley A., Doak J., Nightingale M. G., Hutson J. M. Long-gap esophageal atresia: comparison of delayed primary anastomosis and Oesophageal replacement with gastric tube // J. Pediatr. Surg, No. 49 (12), 2014. pp. 1762–1766.
  7. Nasr A., Langer J. C. Mechanical traction techniques for long-gap esophageal atresia: a critical appraisal // Eur. J. Pediatr. Surg, No. 23 (3), 2013, pp. 191–197.
  8. Petrosyan M., Estrada J., Hunter C., Woo R., Stein J., Ford H. R., et al. Esophageal atresia/tracheoesophageal fistula in very low-birth-weight neonates: improved outcomes with staged repair // J. Pediatr. Surg, No. 44 (12), 2009, pp. 2278–2281.
  9. Huh Y. J., Kim H. Y., Lee S. C., Park K. W., Jung S. E. Comparison of outcomes according to the operation for type A esophageal atresia // Ann. Surg. Treat. Res, No. 86 (2), 2014, pp. 83–90.
  10. Hunter C. J., Petrosyan M., Connelly M. E., Ford H. R., Nguyen N. X. Repair of long-gap esophageal atresia: gastric conduits may improve outcome-a 20 year single center experience // Pediatr. Surg. Int, No. 25 (12), 2009, pp. 1087–1091.
  11. Батаев С. М., Разумовский А. Ю., Степанов Э. А., Захаров А. И. Качество жизни пациентов после колоэзофагопластики, выполненной в детском возрасте // Хирургия. Журнал им. Н. И. Пирогова, №5, 2002. С. 48–54. Batayev S. M., Razumovsky A. Yu., Stepanov E. A., Zakharov A. I. Quality of life after coloesophagoplasty performed in childhood // Hirurgija. Zhurnalim. N. I. Pirogova, No. 5, 2002. P. 48–54. (in Russian)
  12. Maghsoudlou P., Ditchfield D., Klepacka D. H., Shangaris P., Urbani L., Loukogeorgakis S. P., Eaton S., De Coppi P. Isolation of esophageal stem cells with potential for therapy // Pediatr. Surg. Int, No. 30 (12), 2014, pp. 1249–1256.
  13. Pinheiro P. F., Simoes e Silva A. C., Pereira R. M. Current knowledge on esophageal atresia // World J. Gastroenterol, No. 18 (28), 2012, pp. 3662–3672.
  14. Alberti D., Boroni G., Corasaniti L., Torri F. Esophageal atresia: pre and post-operative management // J. Matern Fetal Neonatal Med, No. 24 (1), 2011, pp. 4–6.
  15. Spitz L. Oesophageal atresia // Orphanet J. Rare Dis, No. 2, 2007. P. 24.
  16. Арапова А. В., Щитинин В. Е., Кузнецова Е. В. Опыт лечения новорожденных с атрезией пищевода в сочетании с множественными врожденными пороками развития // Детская хирургия, №6, 2003. С. 41–42. Arapova A.V., Shchitinin V.E., Kuznetsova E.V. Experience of treatment of newborns with esophageal atresia in combination with multiple congenital malformations//Detskajahirurgija, №6, 2003. pp. 41–42. (in Russian)
  17. Sawicka E., Zak K., Boczar M., Ploska-Urbanek B., Mydlak D., Woynarowska M. Surgical treatment of neonates with very low or extremely low birth weight // Med. Wieku Rozwoj, No. 15 (3 Pt 2), 2011, pp. 394–405.
  18. Chang E. Y., Chang H. K., Han S. J., Choi S. H., Hwang E. H., Oh J. T. Clinical characteristics and treatment of esophageal atresia: a single institutional experience // J. Korean Surg. Soc., No. 83 (1), 2012, pp. 43–49.
  19. Friedmacher F., Puri P. Delayed primary anastomosis for management of long-gap esophageal atresia: a metaanalysis of complications and long-term outcome // Pediatr. Surg. Int, No. 28 (9), 2012, pp. 899–906.
  20. Lee H. Q., Hawley A., Doak J., Nightingale M. G., Hutson J. M. Long-gap esophageal atresia: comparison of delayed primary anastomosis and Oesophageal replacement with gastric tube // J. Pediatr. Surg, No. 49 (12), 2014, pp. 1762–1766.
  21. Parolini F., Leva E., Morandi A., Macchini F., Gentilino V., Di Cesare A., et al. Anastomotic structures and endoscopic dilatations following esophageal atresia repair // Pediatr. Surg. Int, No. 29, 2013, pp. 601–605.
  22. Spitz L. Esophageal atresia: past, present, and future // J. Pediatr. Surg. No. 31, 1996, pp. 19–25.
  23. Spitz L. Oesophageal atresia // Orphanet J. Rare Dis. No. 2, 2007. P. 24.
  24. Pieretti R., Shandling B., Stephens C. A. Resistant esophageal atresia associated with reflux after repair of esophageal atresia: A therapeutic approach // J. Pediatr. Surg, No. 9, 1974, pp. 355–357.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2017 Razumovsky A.Y., Alkhasov A.B., Mokrushina O.G., Kulikova N.V., Gebekova S.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: ПИ № ФС 77 - 81892 от 24.09.2021 г.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies