Reoperation for anastomotic complications of esophageal atresia and tracheoesophageal fistula
Reoperation for anastomotic complications of esophageal atresia and tracheoesophageal fistula
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食管闭锁及气管食管瘘吻合口并发症的再次手术治疗
DOI：
10.1016/j.jpedsurg.2015.08.015
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发表时间：
2015-12-01
影响因子：
2.4
通讯作者：
Zheng, Shan
中科院分区：
文献类型：
--
作者：
Zhu, Haitao;Shen, Chun;Zheng, Shan
背景/目的：回顾食管闭锁（EA）和气管食管瘘（TEF）一期修复术后吻合口并发症（ACs）的再手术处理经验，并评价再手术后的疗效。方法：回顾性分析2005 ~ 2014年21例再次手术的EA患者。分析临床特点、再手术原因、ACs的诊断、再手术方式及结果、再手术长期随访情况。结果：复发性TEF (RTEF) 16例（76.2%），严重吻合口狭窄（AS） 4例（19%），吻合口漏（AL） 1例（4.8%）再次手术。食道造影均证实AS和AL。食管镜、支气管镜检查证实RTEF。所有病例均成功再手术。平均手术时间2.7 +/- 0.8小时，术后住院时间15.4 +/- 3.3天。死亡率为4.8%。所有病例术后随访1 ~ 107个月。没有患者出现呼吸或进食问题。所有再手术病例均无严重术后并发症。结论：严重AS、AL及RTEF是EA修复后再手术的重要适应症。再次手术治疗吻合口多发并发症效果显著。(c) 2015 Elsevier Inc.版权所有。
Background/Purpose: The purpose of the study was to review our experience in the re-operative management of anastomotic complications (ACs) following primary repair of esophageal atresia (EA) and tracheoesophageal fistula (TEF) and to assess the outcomes after reoperation.Methods: We retrospectively reviewed 21 EA patients who underwent reoperation from 2005 to 2014. Clinical features, reasons for reoperation, diagnosis of ACs, re-operative procedures and outcomes, as well as long-term follow-up of reoperation were analyzed.Results: Reoperation occurred in 16 recurrent TEF (RTEF) cases (76.2%), 4 severe anastomotic strictures (AS), and 1 anastomotic leakage (AL) cases (19% and 4.8%, respectively). All of AS and AL were confirmed by esophagography. RTEF were confirmed by esophagoscopy and bronchoscopy. All of the cases underwent reoperation successfully. The average operative time and length of post-operative hospital stay were 2.7 +/- 0.8 hours and 15.4 +/- 3.3 days, respectively. The mortality rate was 4.8%. All of the cases were followed up from 1 to 107 months after reoperation. No patients experienced respiratory or feeding issues. No severe postoperative complications were shown in all re-operative cases.Conclusions: ACs including severe AS and AL as well as RTEF are the significant indications for reoperation after EA repair. The reoperation was effective to treat multiple anastomotic complications. (c) 2015 Elsevier Inc. All rights reserved.