Wang Junjie,He Qiuming,Zhong Wei,et al.Programmed management of H-type congenital tracheoesophageal fistula[J].Journal of Clinical Pediatric Surgery,,22():340-344.[doi:10.3760/cma.j.cn101785-202303015-008]
Programmed management of H-type congenital tracheoesophageal fistula
- Keywords:
- Esophageal Atresia; Tracheoesophageal Fistula; Diagnosis; Surgical Procedures; Operative; Treatment Outcome
- Abstract:
- Objective To summarize the clinical efficacy of programmed management for H-type congenital tracheoesophageal fistula (H-TEF).Methods From March 2017 to March 2022,clinical data were retrospectively reviewed for 10 H-TEF children under programmed management.Six neonates developed recurrent cough after feeding and 4 infants had recurrent pneumonia.One case was associated with congenital heart disease and another had hemivertebra deformity of thoracic vertebra.After a definite diagnosis was confirmed by esophagography and/or fiberbronchoscope,gastric tube feeding was initiated.After inflammatory parameters normalized completely or partially and pneumonic change disappeared on chest film,a catheter was placed in fistula under a guidance of fiberbronchoscope.The position of fistula was confirmed by bedside radiography;H-TEF was repair through a cervical approach when fistula was located above T2 level and thoracoscopically below T2.Results Seven cases were confirmed by esophagography and 3 cases by fiberbronchoscope.Catheter was successfully deployed in fistula in all cases before surgery.Seven cases of fistula above T2 were repaired through a right cervical route and 3 cases of fistula below T2 underwent thoracoscopy.Feeding through a gastric tube resumed the next day and esophagography 1 week later.There was no leakage or recurrence during a follow-up period of (8-60) month.Three cases of hoarseness occurred after cervical surgery and recovered at (1-6) month.No dysphagia or recurrence was noted.Conclusion An integrated strategy for H-TEF yields satisfactory outcomes under programmed management.
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Memo
收稿日期:2023-3-5。
基金项目:广东省科技计划项目(2014A020212022);广州市基础研究计划基础与应用基础研究项目(202102080511)
通讯作者:何秋明,Email:qiuminghe@foxmail.com