Nwosu J N, Onyekwulu F A
Department of Otolaryngology, University of Nigeria Teaching Hospital Ituku/Ozalla Enugu.
Niger J Med. 2013 Oct-Dec;22(4):295-8.
To document our 12 years experience in the management of oesophageal atresia and tracheooesophageal fistula.
The study was carried out at the University of Nigeria Teaching Hospital (UNTH) Enugu Nigeria between January 1997 and December 2008. The paediatric ward and theatre records of patients with oesophageal atresia and trachea oesophageal fistula were reviewed. The data extracted include: age at presentation, age at referral, reasons for delay referral (> 24 hrs from birth). Associated anomalies, Time interval from diagnosis to intervention, Operative procedure, and outcome.
Ten patients were studied, eight males and two females, ratio 4:1. They were all referred from outside the study centre. The average age at presentation was 5.3 days with a range of 2-12 days. The mean age at referral was 3.9 days. Two patients died before surgical intervention. The remaining eight that had surgery done, only one was discharged alive to surgical out patient but was lost to follow up.
Delay in arriving at a diagnosis, late referral, associated congenital anomalies and comorbidities contributed to the poor out come. High index of suspicion, early diagnosis and referral, improved facilities and experience of the attending team will make for a favourable out come.
记录我们在食管闭锁和气管食管瘘管理方面的12年经验。
该研究于1997年1月至2008年12月在尼日利亚埃努古的尼日利亚大学教学医院（UNTH）进行。回顾了食管闭锁和气管食管瘘患者的儿科病房和手术记录。提取的数据包括：就诊年龄、转诊年龄、延迟转诊的原因（出生后>24小时）、相关畸形、从诊断到干预的时间间隔、手术程序和结果。
研究了10例患者，8例男性和2例女性，比例为4:1。他们均从研究中心外转诊而来。就诊时的平均年龄为5.3天，范围为2至12天。转诊时的平均年龄为3.9天。2例患者在手术干预前死亡。其余8例接受手术的患者中，只有1例存活出院至外科门诊，但失访。
诊断延迟、转诊晚、相关先天性畸形和合并症导致了不良结局。高度的怀疑指数、早期诊断和转诊、改善设施以及主治团队的经验将带来良好的结局。
