Gurskas Pranas, Ivanauskas Aidas
Center of Pediatric Surgery, Vilnius University Children's Hospital, Santariskiu 7, 2600 Vilnius, Lithuania.
Medicina (Kaunas). 2004;40 Suppl 1:166-9.
The aim of study is to review patients with esophageal atresia, treated by means of delayed primary esophageal anastomosis at Vilnius University Children's Hospital.
Study was performed by retrospective analysis of medical records including period of 1992-2002, and clinical evaluation of late results. There were 97 patients with esophageal atresia, and 17 (17.5%) of them were selected for delayed primary esophageal anastomosis. This method was introduced in year 1993.
Out of 17 patients selected for delayed primary esophageal anastomosis; 4 died from septic complications. Early complications included leakage of the anastomosis for six patients; four of them recovered after conservative treatment. Esophageal stricture occurred in 5 patients, and was resolved by bouggienage. The follow-up of 13 survivors at present is from 2 to 10 years. Gastroesophageal reflux was diagnosed in 4 patients, one of them was cured with Nissen fundoplication; others received medication. All at present are developing normally. None of them suffer from dysphagia. They do not need esophageal dilatation.
We have found that in this group of patients elongation of esophageal segments and delayed primary esophageal anastomosis is effective and esophagus saving procedure.
本研究旨在回顾维尔纽斯大学儿童医院采用延迟一期食管吻合术治疗食管闭锁患者的情况。
通过回顾性分析1992年至2002年期间的病历进行研究,并对远期结果进行临床评估。共有97例食管闭锁患者,其中17例(17.5%)被选行延迟一期食管吻合术。该方法于1993年引入。
在17例被选行延迟一期食管吻合术的患者中,4例死于败血症并发症。早期并发症包括6例吻合口漏;其中4例经保守治疗后康复。5例发生食管狭窄,通过探条扩张得以解决。目前13例幸存者的随访时间为2至10年。4例诊断为胃食管反流,其中1例经尼森胃底折叠术治愈;其他患者接受药物治疗。目前所有患者均发育正常。他们均无吞咽困难。他们无需食管扩张。
我们发现,在这组患者中,食管段延长和延迟一期食管吻合术是一种有效的保食管手术。