Kong Chihuan,Wu Yurui,Li Long,et al.Role of gastroscopy during operation of piriform fossa fistula in children[J].Journal of Clinical Pediatric Surgery,,():877-881.[doi:10.3760/cma.j.cn101785-202312005-014]
Role of gastroscopy during operation of piriform fossa fistula in children
- Keywords:
- Piriform Fossa Fistula; Gastroscopy; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the role of gastroscopy during operation of pediatric piriform sinus fistula (PSF). Methods A retrospective analysis was conducted for the relevant clinical data of 5 children hospitalized with PSF from December 2020 to July 2021.The recurrence factors and managements were collected and diagnostic and therapeutic experience summarized. Results In this cohort, there were 2 boys and 3 girls with an average age of 57(32-132) month.All of them had a previous history of surgery.There were incision/drainage of left cervical abscess (n=3) and left fistulotomy (n=2).They were re-hospitalized for psilateral recurrence of PSF.Preoperative neck ultrasound and upper gastrointestinal imaging were performed along with computed tomography (CT) and magnetic resonance imaging (MRI).Bilateral PSF was detected during upper gastrointestinal imaging.Under the same anesthesia, gastroscopy was performed.In all 5 cases, fistula was completely freed to submucosal area of fistula opening.Internal opening was ligated and fistula was removed.There was no postoperative hoarseness.Eating resumed the next day and discharge occurred after 3-day anti-inflammatory treatment.Postoperative pathological examination revealed that submitted tissue consisted of covered columnar epithelium and squamous columnar epithelial lumens.Follow-up for more than 1 year after surgery showed no recurrence. Conclusions Epithelial tissue is present in piriform sinus fistula.A complete removal of fistula and a complete ligation of fistula opening are essential for preventing postoperative recurrence of PSF.Due to the application of gastroscopy during the entire surgical process, cervical approach surgery can completely remove fistula and close fistula opening.It not only avoids accidental injury to surrounding tissues but also effectively prevents postoperative recurrence.
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Memo
收稿日期:2023-12-3。
基金项目:中国医学科学院小儿外科微创诊疗创新单元(2021RU015)
通讯作者:李龙，Email: lilong23@126.com