Gu Yichao,Hua Kaiyun,Liao Junmin,et al.Management strategies for corrosive tracheoesophageal fistula and concurrent esophageal stricture in children[J].Journal of Clinical Pediatric Surgery,,():382-386.[doi:10.3760/cma.j.cn101785-202503105]
Management strategies for corrosive tracheoesophageal fistula and concurrent esophageal stricture in children
- Keywords:
- Corrosive Tracheoesophageal Fistula; Button Battery; Esophageal Stricture; Esophageal Dilation
- Abstract:
- Objective To explore the management strategies and outcomes of corrosive tracheoesophageal fistula (TEF) with or without esophageal stricture in children.Methods For this retrospective case series,the relevant clinical data were retrospectively reviewed for 10 hospitalized children of corrosive TEF between October 2018 and October 2024.There were 4 boys and 6 girls.The causes were button batteries (n=7) and non-button battery corrosive agents (n=3).Six of them were complicated with esophageal stricture.Clinical profiles,type of ingested corrosive substances,complications,therapeutic strategies and clinical outcomes were recorded.Results Among 7 cases of button battery-induced TEF,3 achieved spontaneous closure with conservative measures with a median healing time of 3(2-4) month while 4 were surgically repaired.Three cases of non-button battery-induced TEF were operated with a median time to surgery of 12(5-24) month post-injury.Six cases developed concomitant esophageal stricture.One case of severe stricture underwent esophageal dilation before fistula healing while the remainders underwent no pre-healing dilation.After fistula closure,4 cases started esophageal dilation at a mean of 2.6 months with a median of 14 dilation sessions.During follow-ups,there were normal growth & development (n=8),poor weight gain (n=1) and persistent TEF requiring jejunal feeding (n=1).Conclusions Button battery-induced corrosive TEF in children offers the potential for spontaneous closure.Conservative management may be considered as an initial approach.Surgical intervention is recommended if fistula fails to heal within 6 months post-injury.For children with concomitant esophageal stricture,initiating dilation after fistula closure proves safe and effective.
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Memo
收稿日期:2025-3-28。
基金项目:北京高层次创新创业领军人才计划(20250058); 北京市科学技术委员会自主项目(Z211100002921062)
通讯作者:黄金狮,Email:jsdr2002@126.com