Tao Junfeng,Huang Jinshi,Chen Kuai,et al.Comparison of management methods of congenital esophageal atresia with esophago tracheal fistula[J].Journal of Clinical Pediatric Surgery,,20():1122-1126.[doi:10.12260/lcxewkzz.2021.12.004]
Comparison of management methods of congenital esophageal atresia with esophago tracheal fistula
- Keywords:
- Esophageal Atresia/SU; Postoperative Complications/SU; Recurrent Tracheoesophageal FistulaTracheoesophageal Fistula; Thoracoscopy
- CLC:
- R725.621.3;R571;R726.1
- Abstract:
- Objective To explore the efficacies of different treatments for broken end of esophagotracheal fistula (ETF) in thoracoscopic esophageal atresia on its recurrence.Methods From April 2014 to April 2021, clinical data were retrospectively reviewed for 110 children with congenital esophageal atresia undergoing thoracoscopy.According to different treatments of ETF, they were divided into group A (n=40, one ligation and one suture), group B (n=40, clamping with Hem-o-lok) and group C (n=30, continuous suture embedding).The recurrence rate of postoperative ETF, the incidence of postoperative esophago anastomotic fistula and time to handle broken end of ETF were compared among three groups.Results During a follow-up period of over 6 months, there was no loss of follow-up or mortality.There were 9 recurrent ETF cases with an overall recurrence rate ofs 8.2%; Anastomotic leakage occurred in 15 cases with an overall incidence of anastomotic leakage of 13.6%.The recurrence rates of tracheal fistula of three groups were 5 (12.5%), 4(10%) and 0(0%); The incidence of anastomotic leakage was 6(15%), 5(12.5%) and 4(13.3%) respectively.And χ2 and t tests were utilized.The recurrence rate of tracheal fistula was lower in group C than that in group A/B (P<0.05); No significant difference existed in the incidence of anastomotic leakage among three groups (P>0.05).Time for dealing with brokcen end of ETF was (15.5±4.5), (7.5±2.5) and (26.5±5.5) min respectively.Paired t-test indicated that handling time was greater in group C than that in group A/B.Conclusion New treatment of ETF is more time-consuming than ligation/suture and Hem-o-lok clamping.However, it can avoid or lower the postoperative incidence of ETF.Due to a small number of case studies at a single center, larger clinical trials at multiple centers are required for verifications.
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Memo
收稿日期:2021-07-20。
基金项目:江西省卫生健康委普通科技计划（编号：20195540）
通讯作者:陶强,Email:taoqiang_2008@126.com