Wang Peize,Zhao Yong,Yang Shen,et al.Clinical characteristics and treatments of congenital esophageal atresia type V[J].Journal of Clinical Pediatric Surgery,,22():318-322.[doi:10.3760/cma.j.cn101785-202111011-004]
Clinical characteristics and treatments of congenital esophageal atresia type V
- Keywords:
- Esophageal Atresia; Diagnosis; Surgical Procedures; Operative; Treatment Outcome
- Abstract:
- Objective To explore the clinical characteristics,diagnosis and therapeutic principles of congenitalesophageal atresia type V.Methods Retrospective analysis was conducted for clinical data of children with congenital esophageal atresia type V from March 2007 to December 2020.There were 16 boys and 24 girls.The relevant clinical manifestations,auxiliary examination results,therapeutic principles and outcomes were recorded.Results Among them,27 (80.0%) were diagnosed within 1 year of age.Clinical manifestations included ingesting choking (87.5%) and recurrent pneumonitis (62.5%).A definite diagnosis was made by esophagography and/or fiberoptic bronchoscopy with a positive rate of 97.4% and 100.0% respectively.And 34 cases of fistula at C7-T2 were repaired through a cervical approach.Thoracic approach was selected for 6 cases of fistula at T2 -T4.Thirty-two cases were cured.Postoperative esophagography revealed a second fistula (n=1).Recurrent laryngeal nerve injury was present in 5 cases.One child of fistula repairing through a thoracic approach had anastomotic leak and was cured after 1-month conservative treatment.One child died from respiratory failure.Thirty-six cases were followed up and 3 cases became lost.Tracheoesophageal fistula recurred in 3 cases and was cured after reoperation.One case of esophageal stenosis was cured after 5 dilations.The remainders recovered well.Conclusion Clinical symptoms of congenital esophageal atresia type V are non-typical so that it may be easily misdiagnosed.Esophagography and fiberoptic bronchoscopy aid in a definite diagnosis.Surgery has an excellent efficacy.Postoperative recurrent laryngeal nerve injury should be avoided.
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Memo
收稿日期:2021-11-11。
基金项目:首都临床特色诊疗技术研究与转化应用(Z211100002921062)
通讯作者:黄金狮,Email:jsdr2002@126.com