Tazuke Y, Kawahara H, Yagi M, Yoneda A, Soh H, Maeda K, Yamamoto T, Imura K
Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi-city, Japan.
J Pediatr Surg. 1999 Aug;34(8):1291-3. doi: 10.1016/s0022-3468(99)90174-4.
A male infant with congenital cardiac anomalies and esophageal atresia with tracheoesophageal fistula (EA-TEF) showed intractable respiratory symptoms after delayed primary repair of EA-TEF. Computed tomography demonstrated that the trachea was compressed by the enlarged aorta. Artificial ventilation was necessary even after aortopexy performed at 2 months of age. At 140 days of age, an expandable metallic stent (Palmaz stent) was inserted through a rigid bronchoscope into the trachea underfluoroscopic control. His respiratory status improved dramatically, and he was extubated in 18 hours. Although the follow-up period has been 9 months, the short-term result is satisfactory. The expandable metallic stent placement should be considered in patients with EA-TEF who show intractable respiratory symptoms caused by tracheomalacia.
一名患有先天性心脏异常以及食管闭锁合并气管食管瘘(EA-TEF)的男婴,在EA-TEF延迟一期修复术后出现了难治性呼吸症状。计算机断层扫描显示气管被扩张的主动脉压迫。即使在2个月大时进行了主动脉固定术,仍需要人工通气。在140天大时,在荧光镜控制下通过硬支气管镜将可扩张金属支架(Palmaz支架)插入气管。他的呼吸状况显著改善,并在18小时后拔管。尽管随访期为9个月,但短期结果令人满意。对于因气管软化而出现难治性呼吸症状的EA-TEF患者,应考虑放置可扩张金属支架。