Zhang Ning,Liu Fengli,Ma Tongsheng,et al.Study on the causes and treatment strategies of anastomotic leakage after operation for type Ⅲ congenital esophageal atresia[J].Journal of Clinical Pediatric Surgery,,20():1127-1131.[doi:10.12260/lcxewkzz.2021.12.005]
Study on the causes and treatment strategies of anastomotic leakage after operation for type Ⅲ congenital esophageal atresia
- Keywords:
- Esophageal Atresia/CN; Esophageal Atresia/SU; Postoperative Complications/SU; Anastomotic Leak/SU
- CLC:
- R571;R726.1
- Abstract:
- Objective To investigate the causes and treatment strategies of anastomotic leakage after operation of type Ⅲ congenital esophageal atresia.Methods The clinical data of 116 cases with type III congenital esophageal atresia admitted to Children’s Hospital Affiliated to Medical University from January 2012 to September 2020 were retrospectively analyzed.All cases were divided into two groups according to the presence or absence of anastomotic leakage after operation of esophageal atresia.25 cases were included in the observation group with anastomotic leakage, and 91 cases were included in the control group.Gender, gestational age, weight at admission, age at the time of operation, operation time, combined malformation, hospital stay, type III esophageal atresia (Ⅲ a or Ⅲ b), preoperative albumin level, time of ventilator use, presence of esophageal lengthening surgery (Livaditis operation), postoperative complications of patients, occurrence of anastomotic stenosis and recurrence of esophagotracheal fistula were compared between the two groups, and the influencing factors of anastomotic leakage were analyzed.Results There were no significant differences between the two groups in gender, operation age, operation time and postoperative anastomotic stenosis (P>0.05).The gestational age was (37.5±3.00) weeks in the observation group and (38.7±2.0) weeks in the control group, the difference was statistically significant (P=0.016), and the body weight at admission was (2.49±0.66) kg in the observation group and (2.75±0.51) kg in the control group, the difference was statistically significant (P=0.040); In the observation group, the patients with type ⅢA esophageal atresia, malformations, malformations requiring simultaneous operation, Livaditis operation and recurrence of esophagotracheal fistula were significantly more than those in the control group (P<0.05).Patients with normal pre-operation albumin level in the observation group was significantly less than those in the control group (P=0.035); The hospitalization time was (36.9±21.9) days in the observation group and (19.6±6.0) days in the control group, the difference was statistically significant (P<0.001), and the time of ventilator use was (6.96±4.73) days in the observation group and (3.80±2.74) days in the control group, the difference was statistically significant (P<0.001).Conclusion The gestational age, weight at admission, preoperative albumin level, type of esophageal atresia, the presence of Livaditis operation and associated malformations are closely related to postoperative anastomotic leakage for children with type III congenital esophageal atresia.Most of the children with anastomotic leakage heal after conservative treatment, only a few cases need reoperations.
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Memo
收稿日期:2021-07-21。
通讯作者:刘丰丽,Email:xzsetyywklfl@126.com