Rintala R J, Pakarinen M P
Department of Pediatric Surgery, Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland.
Eur J Pediatr Surg. 2013 Jun;23(3):219-25. doi: 10.1055/s-0033-1347912. Epub 2013 Jun 4.
After repair of esophageal atresia (EA) in a newborn, esophageal dysmotility presenting as dysphagia and symptomatic gastroesophageal reflux are common. Significant esophageal morbidity associated with EA extends into adulthood. In adulthood approximately one-fifth of the patients have developed epithelial metaplastic changes, one-third of these have intestinal metaplasia (Barrett esophagus). Surgical complications, increasing age, and impaired esophageal motility predict the development of epithelial metaplasia after repair of EA. To date, worldwide, eight cases of esophageal cancer have been reported in young adults treated for EA. Incidence of esophageal cancer after EA repair is very much likely to increase in the future. Life-long endoscopic follow-up is warranted in patients with EA.
新生儿食管闭锁(EA)修复术后,常见以吞咽困难和有症状的胃食管反流为表现的食管动力障碍。与EA相关的显著食管病变会延续至成年期。在成年期,约五分之一的患者会出现上皮化生改变,其中三分之一有肠化生(巴雷特食管)。手术并发症、年龄增长和食管动力受损预示着EA修复术后上皮化生的发生。迄今为止,全球已报道8例接受EA治疗的年轻成人发生食管癌。EA修复术后食管癌的发病率未来很可能会增加。EA患者有必要进行终身内镜随访。