TREATMENT OF PATIENTS LOW WEIGHT WITH ESOPHAGUS ATRESIA

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Abstract

Introduction. Surgical treatment of intestinal atresia with distal tracheoesophageal fistula involves resection of fistula and intestinal primary anastomosis. However, premature children often have complications associated with delayed anastomosis. Thus, an optimal surgical approach is not determined. Purpose. Analyzing treatment results in newborns with intestinal atresia and very low weight. Materials and methods. Treatments outcomes in infants with intestinal atresia and very low weight (less than 1500 g) from 2008 to 2017 were assessed retrospectively. The patients were divided into 2 groups: (1) fistula dressing and crossing with subsequent delayed anastomosis reconstruction and (2) primary anastomosis. Demographic, surgical and postoperative complications were compared. Results. 23 preterm children with IA/TEF were operated. Twelve patients (52%) underwent primary anastomosis, whereas 11 (48%) of them had a stepwise surgery. Anastomotic leak confirmed by esophagram was similar in both groups (17% and 18%). Stenosis was more common in step-wise surgery (83%) as compared to the group of primary anastomosis (27%) (р<0.05). The esophagus was preserved in two patients who underwent step-wise surgery. 4 patients had coloesophagoplasty. The postoperative period was similar in both groups. 6 patients (50%) from the step-wise group and 5 patients (45%) from the group of primary anastomosis died. Conclusion. Staging plasty of IA/TEF in newborns does not improve the quality of life. In this group, gastro- and esophagostomy exteriorization is a preferable surgical approach.

About the authors

A. Y. Razumovskiy

Pirogov Russian National Research Medical University;
N.F.Filatov Children’s Hospital of Moscow Healthcare Ministry

Author for correspondence.
Email: 1595105@mail.ru
Dr. Sci (Med), Professor, Corresponding Member, Russian Academy of Sciences, Pirogov Russian National Research Medical University Россия

O. G. Mokrushina

Pirogov Russian National Research Medical University;
N.F.Filatov Children’s Hospital of Moscow Healthcare Ministry

Email: mokrushina@yandex.ru
Dr. Sci (Med), Professor, pediatric surgeon of the neonatal surgery department, N. F. Filatov Children’s Hospital of Moscow Healthcare Ministry Россия

I. I. Afukov

Pirogov Russian National Research Medical University;
N.F.Filatov Children’s Hospital of Moscow Healthcare Ministry

Email: fake@neicon.ru
Cand.Sci (Med), N. F. Filatov Children’s Hospital of Moscow Healthcare Ministry Россия

V. S. Shumikhin

Pirogov Russian National Research Medical University;
N.F.Filatov Children’s Hospital of Moscow Healthcare Ministry

Email: fake@neicon.ru
Cand.Sci (Med), N. F. Filatov Children’s Hospital of Moscow Healthcare Ministry Россия

O. V. Koshko

N.F.Filatov Children’s Hospital of Moscow Healthcare Ministry

Email: fake@neicon.ru
Anesthesiologist of the anesthesiology and intensive care unit with an operating unit, N. F. Filatov Children’s Hospital of Moscow Healthcare Ministry Россия

S. K. Emirbekova

N.F.Filatov Children’s Hospital of Moscow Healthcare Ministry

Email: fake@neicon.ru
Cand.Sci (Med), anesthesiologist of the anesthesiology and intensive care unit with an operating unit, N. F. Filatov Children’s Hospital of Moscow Healthcare Ministry Россия

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Copyright (c) 2019 Razumovskiy A.Y., Mokrushina O.G., Afukov I.I., Shumikhin V.S., Koshko O.V., Emirbekova S.K.

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