Moukheiber Alain K, Camboulives Jean, Guys Jean Michel, Riberi Alberto, Paut Olivier, Triglia Jean Michel
Department of Pediatric Otolaryngology-Head and Neck Surgery, La Timone Children's Hospital, Marseille Medical School, Marseille, France.
Ann Otol Rhinol Laryngol. 2002 Dec;111(12 Pt 1):1076-80. doi: 10.1177/000348940211101203.
Laryngotracheoesophageal clefts (LTECs) are rare congenital defects of variable severity depending on the extent of malformation. Management of a complete LTEC represents a major surgical and anesthetic challenge. The main problems are achieving adequate operative exposure and maintaining ventilatory support during and after the operation. We describe correction of a type IV LTEC extending down to the carina in an infant who had respiratory distress at birth. Surgical repair was achieved in a single stage by an anterior sternotomy approach on the 11th day of life. The procedure was facilitated by cardiopulmonary bypass. After the operation, the infant was intubated, mechanically ventilated, and sedated. Nissen fundoplication and gastrostomy were carried out on the 11th postoperative day. The child was extubated on the 12th postoperative day. The rationale for this method and its advantages in comparison with other surgical approaches are discussed.
喉气管食管裂（LTECs）是一种罕见的先天性缺陷，其严重程度因畸形程度而异。完全性LTEC的治疗是一项重大的外科和麻醉挑战。主要问题是在手术过程中及术后获得足够的手术暴露并维持通气支持。我们描述了一名出生时患有呼吸窘迫的婴儿，其IV型LTEC向下延伸至隆突的矫正情况。在出生后第11天通过前正中胸骨切开术入路进行了一期手术修复。体外循环辅助了手术过程。术后，婴儿进行了气管插管、机械通气和镇静。术后第11天进行了nissen胃底折叠术和胃造口术。术后第12天患儿拔除气管插管。讨论了该方法的原理及其与其他手术方法相比的优势。
