Hikida Shigeki, Tanaka Yoshiaki, Tsuru Tomomitsu, Akiyoshi Kenjiro, Asagiri Kimio, Nakamizo Hirotaka, Soejima Hiroko, Ohtani Mari, Fukahori Suguru, Kobayashi Hidefumi, Kaida Akiko, Asagawa Takahiro, Mizote Hiroyoshi
Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0031, Japan.
Kurume Med J. 2003;50(3-4):139-42. doi: 10.2739/kurumemedj.50.139.
Despite the numerous approaches described for the management of neonates with "long gap" esophageal atresia, controversy still exists as to the preferred method. Delayed primary anastomosis is probably the most frequently adopted practice but often the native esophagus is abandoned. We report a case of a 2.98 kg newborn with pure esophageal atresia. Although the elongation of the distal esophageal pouch by mechanical bougienage was initiated at 1 year and 8 months, a successful tension-free anastomosis with minimum dissection of the lower esophagus was performed at 2 years and 7 months. Her postoperative quality of life has been quite excellent. This report emphasizes that a tension-free anastomosis without operating on the lower esophagus and stomach is essential for the treatment of long-gap esophageal atresia.
尽管针对“长间隙”食管闭锁新生儿的治疗描述了众多方法，但关于首选方法仍存在争议。延迟一期吻合术可能是最常采用的做法，但通常会舍弃原生食管。我们报告一例体重2.98千克的单纯食管闭锁新生儿病例。尽管在1岁8个月时开始通过机械扩张使远端食管袋延长，但在2岁7个月时成功进行了无张力吻合，且对下食管的分离最少。她术后的生活质量非常好。本报告强调，不对下食管和胃进行手术的无张力吻合对于长间隙食管闭锁的治疗至关重要。
