TREATMENT OF PATIENTS LOW WEIGHT WITH ESOPHAGUS ATRESIA

封面


如何引用文章

全文:

详细

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.

作者简介

A. Razumovskiy

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

编辑信件的主要联系方式.
Email: 1595105@mail.ru
Dr. Sci (Med), Professor, Corresponding Member, Russian Academy of Sciences, Pirogov Russian National Research Medical University 俄罗斯联邦

O. 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 俄罗斯联邦

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 俄罗斯联邦

V. 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 俄罗斯联邦

O. 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 俄罗斯联邦

S. 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 俄罗斯联邦

参考

  1. Немилова Т. К., Баиров В. Г., Каган А. В., Караваева С. А., Леваднев Ю. В., Любименко В. А. Атрезия пищевода: 48-летний опыт лечения в Санкт-Петербурге. Детская хирургия. 2003;(6):14–16
  2. Разумовский А. Ю., Ханвердиев Р. А. Непосредственные результаты торакоскопической коррекции атрезии пищевода у новорожденных. Детская хирургия, 2011;(4): 4–9.
  3. Spitz L. Oesophageal atresia. Orphanet J. Rare Dis. 2007; 2:248. DOI: dx.doi.org/10.1186/1750–1172–2–24
  4. Driver C. P., Bruce J. Primary reconstruction of esophageal atresia with distal tracheoesophageal fistula in a 740-g infant. J. Pediatr. Surg. 1997; (32):1488–9. doi: 10.1016/S0022–3468(97)90571–6
  5. Schaarschmidt K., Willital G. H., Jorch G. Delayed primary reconstruction of an esophageal atresia with distal tracheoesophageal fistula in an infant weighing less than 500 g. J. Pediatr. Surg. 1992; 27:1529–31 doi.org/10.1016/0022– 3468(92)90495-S
  6. Ito K., Ashizuka S., Kurobe M. Delayed primary reconstruction of esophageal atresia and distal tracheoesophageal fistula in a 471-g infant. Int. J. Surg. Case Rep. 2013; 4:167–9. doi: 10.1016/j.ijscr.2012.11.010
  7. Hannon E. J., Billington J., Kiely E. M., Pierro A., Spitz L., Cross K., J. I. Oesophageal atresia is correctable and survivable in infants less than 1 kg. Pediatr. Surg. Int. 2016; (32):571–6. doi: 10.1007/s00383–015–3851–4
  8. Zani A., Wolinska J., Cobellis G., Priscilla P. L. Chiu, Pierro A. Outcome of esophageal atresia/tracheoesophageal fistula in extremely low birth weight neonates (Pediatr. Surg. Int. 2016; (32):83–8. doi: 10.1007/s00383–015– 3816–7
  9. 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. 2012; 83(1):43–9. doi: 10.4174/jkss.2012.83.1.43
  10. Aminde L. N., Ebenye V. N., Arrey W. T., Takah N. F., Awungafac G. Oesophageal atresia with tracheo-oesophageal fistula in a preterm neonate in Limbe, Cameroon: case report and brief literature review. BMC Res. Notes. 2014; 7(7):692. doi: 10.1186/1756–0500–7–692
  11. Подкаменев В. В., Новожилов В. А., Козлов Ю. А., Валеев В. В., Подкаменев А. В. Клиническое прогнозирование при атрезии пищевода у новорожденных. Вопросы диагностики в педиатрии. 2009; 1(5):49–54.
  12. Seitz G., Warmann S. W., Schaefer J. Primary repair of esophageal atresia in extremely low birth weight infants: a single center experience and review of the literature. Biol. Neonate. 2006; (90):247–51. doi: 10.1159/000094037
  13. Lopez, P.J., Keys, C., Pierro, A., Drake, D.P., Kiely, E.M., Curry, J.I. and Spitz, L. Oesophageal atresia: Improved outcome in high-risk group? J. of Pediatric. Surgery. 2006; (41):331–4. doi: 10.1016/j.jpedsurg.2005.11.009
  14. Margain L., Perez-Etchepare E., Varlet F., Lopez M. Lower esophageal banding in extremely low birth weight infants with esophageal atresia and tracheoesophageal fistula is a life saving practice followed by a successful delayed primary thoracoscopy reconstruction. J. Pediatr. Surg. 2015; (50):489–92. doi: 10.1016/j.jpedsurg.2014.10.055
  15. Alexander F., Johanningman J., Martin L. W. Staged repair improves outcome of high-risk premature infants with esophageal atresia and tracheoesophageal fistula. J. Pediatr. Surg. 1993; 28(2):151–4. doi: 10.1016/S0022–3468(05)80261–1
  16. Petrosyan M., Estrada J., Hunter C. Esophageal atresia/tracheoesophageal fistula in very low-birth-weight neonates: improved outcomes with staged repair. J. Pediatr. Surg. 2009; 44:2278–81. doi: 10.1016/j.jpedsurg.2009.07.047
  17. Kouji N., Genshirou E., Risa T., Yoshiaki R., Tomoaki T. Current profile and outcome of 100 esophageal atresia patients in the Kyushu area of Japan. Open Journal of Pediatrics. 2013; (3):239–42. doi: 10.4236/ojped.2013.33042
  18. Chroudhury S., Aschcraft K. W., Sharp R. J., Murphy J. P., Snyder C. L. and Sigalet D. L. Survival of patients with esophageal esophageal atresia: Influence of birth weight, cardiac anomaly, and late respiratory complications. Journal of Pediatric Surgery. 1999; 34:70–4. doi: 10.1016/S0022–3468(99)90231–2

补充文件

附件文件
动作
1. JATS XML
下载

版权所有 © Razumovskiy A.Y., Mokrushina O.G., Afukov I.I., Shumikhin V.S., Koshko O.V., Emirbekova S.K., 2019

Creative Commons License
此作品已接受知识共享署名-非商业性使用-禁止演绎 4.0国际许可协议的许可。
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.


##common.cookie##