Russian Journal of Pediatric Surgery, Anesthesia and Intensive CareRussian Journal of Pediatric Surgery, Anesthesia and Intensive CareРоссийский вестник детской хирургии, анестезиологии и реаниматологии2219-40612587-6554Eco-Vector66710.17816/psaic667ReviewsОбзорыResearch ArticleEsophageal atresia — state of the art (review of literature on the PUBMED base)Атрезия пищевода — современное состояние проблемы (обзор литературы по базе PUBMED)https://orcid.org/0000-0002-0672-2827RothenbergStevenРотенбергСтивен
United States

руководитель Департамента детской хирургии; клинический профессор хирургии в хирургическом колледже

steverberg@aol.comhttps://orcid.org/0000-0003-2313-897XKozlovYury А.КозловЮрий Андреевич
Russian Federation

Dr. Sci. (Med.), Head of department of neonatal surgery; Dr. Sci. (Med.), Head of department of neonatal surgery

д-р мед. наук, заведующий отделением хирургии новорожденных; профессор кафедры детской хирургии

yuriherz@hotmail.comRocky Mountains Children’s HospitalДетский госпиталь Скалистых горColumbia University College of SurgeonsКолумбийский университетIrkutsk Municipal Pediatric Clinical HospitalОбластное государственное автономное учреждение здравоохранения Городская Ивано-Матренинская детская клиническая больницаIrkutsk State Medical UniversityФедеральное государственное бюджетное образовательное учреждение высшего профессионального образования «Иркутский государственный медицинский университет» Министерства здравоохранения Российской Федерации251220201033273380211202012012021Copyright ©; 2020, Rothenberg S., Kozlov Y.А.Copyright ©; 2020, Ротенберг С., Козлов Ю.А.2020Rothenberg S., Kozlov Y.А.Ротенберг С., Козлов Ю.А.https://creativecommons.org/licenses/by-nc-nd/4.0https://rps-journal.ru/jour/article/view/667

Esophageal atresia is fundamentally important in pediatric surgery, as its treatment results create an accurate portrait of the standards of surgical care, which is provided by any medical institution. Cameron Haight performed the first successful reconstruction of the esophagus’ malformation relatively recently — just over 70 years ago. Advances in neonatal surgery, technology and advances in neonatal intensive care have dramatically improved treatment outcomes for this disease. Current mortality from this developmental abnormality has become minimal, despite its frequent association with other malformations. A revolutionary approach to the treatment of esophageal atresia was developed by Steven Rothenberg in 1999, the pioneer and legend of pediatric minimally invasive surgery. In 1999, he revolutionized esophageal anastomosis by thoracoscopy. The innovative concept of the minimally invasive approach ensured minimal trauma to patients, thereby providing the possibility of rapid postoperative recovery of patients and reducing the length of their surgical hospital stay. This literature review raises the main controversy in the surgical treatment of esophageal atresia in the 21st century. Emphasis is placed on the study of the role of minimally invasive surgery and the treatment of concomitant abnormalities associated with gastroesophageal reflux and tracheomalacia. As part of the study, a description of all the latest technologies, advances in technical and scientific terms, solutions, exceptional experience, and competence in developing and implementing minimally invasive operations in young children. These developments changed the direction of pediatric surgery and improved the quality of surgical care for children with congenital malformation of the esophagus and how they were performed.

Атрезия пищевода — принципиально важная и фундаментальная позиция в детской хирургии, так как результаты ее лечения создают точный портрет стандартов хирургической помощи, который оказывает любое отдельное лечебное учреждение. Первая успешная реконструкция аномалии развития пищевода была выполнена Кэмероном Хайтом относительно недавно — чуть более семидесяти лет назад. Прогресс технологий в хирургии новорожденных, а также успехи в неонатальной интенсивной терапии позволили радикально улучшить результаты лечения этого заболевания, так что текущая смертность от этой аномалии развития стала минимальной, несмотря на частую ассоциацию с другими мальформациями. Революционный подход в лечении атрезии пищевода, предпринятый впервые автором этой научной работы Стивеном Ротенбергом в 1999 г., — пионером и легендой детской минимально инвазивной хирургии, произвел технологический переворот, который позволил выполнять пищеводный анастомоз при помощи торакоскопии. Инновационная концепция минимально инвазивного подхода обеспечила минимальную травму пациентов, предоставив тем самым возможность быстрого послеоперационного восстановления больных и сокращения сроков их пребывания в хирургическом госпитале. В настоящем обзоре литературы описаны основные споры, которые существуют в хирургическом сообществе при лечении пациентов с атрезией пищевода в XXI в. Особый акцент сделан на изучении роли минимально инвазивной хирургии и лечении сопутствующих аномалий, связанных с гастроэзофагеальным рефлюксом и трахеомаляцией. В рамках исследования рассмотрены все новейшие технологии, передовые в техническом и научном плане решения, исключительный опыт и компетенции в разработке и внедрении малоинвазивных операций у маленьких детей, которые изменили направление развития детской хирургии и повысили качество хирургической помощи детям с врожденной аномалией развития пищевода.

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