Yuan Like,Xiao Shangjie,Xu Lu,et al.Clinical features and prognostic factors of congenital esophageal atresia[J].Journal of Clinical Pediatric Surgery,,22():323-328.[doi:10.3760/cma.j.cn101785-202107026-005]
Clinical features and prognostic factors of congenital esophageal atresia
- Keywords:
- Esophageal Atresia; Postoperative Complications; Diagnosis; Surgical Procedures; Operative; Prognosis
- Abstract:
- Objective To explore the clinical features and prognostic factors of congenital esophageal atresia (CEA) to provide references for clinical diagnosis,treatment decision-making and prognostic evaluations.Methods Retrospective analysis was conducted for clinical data of 285 CEA patients from January 2014 to December 2020.There were 176 boys and 109 girls with a birth weight of (1 080-3 980)(2 740±506) gram.And 64 cases were premature and 195 cases associated with other system malformation.Gross types were Ⅰ(n=13),Ⅱ(n=2),Ⅲ(n=264),Ⅳ(n=2) and Ⅴ(n=4).Results Thirty-four cases gave up surgery because of premature birth,low birth weight or associated malformations.Among 251 operated cases,241(96.02%) survived and 10(3.98%) died.No statistically significant differences existed in gender and associated malformation (congenital heart disease,anal atresia,digestive tract malformation & digestive tract perforation) between death and survival group (P>0.05); statistically significant differences existed in premature birth and very low birth weight (P<0.05).Postoperative complications included esophageal anastomotic leakage (n=40,15.94%),esophageal anastomotic stenosis (n=62,24.70%) and esophagotracheal fistula (n=8,3.19%).Among 230 cases of type Ⅲ,thoracoscopy (n=123) and thoracotomy (n=107) were performed.No significant inter-group differences existed in anastomotic leakage (χ2=0.413,P=0.520),anastomotic stenosis (χ2=0.302,P=0.583),esophagotracheal fistula recurrence (χ2=3.016,P=0.082) or cure rate (χ2=0.431,P=0.512).Conclusion Not associated with congenital heart disease,anal atresia,gastrointestinal malformation or digestive tract perforation,poor prognosis of CEA is correlated with preterm birth and very low birth weight.Thoracoscopy for type III CEA does not increase the probability of complications.However,long-term follow-ups and multi-center studies are still required.
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Memo
收稿日期:2021-7-14。
基金项目:广州市科技计划项目(201804010290)
通讯作者:肖尚杰,Email:drsiow@163.com