食管闭锁修复术后无需常规进行术后食管造影。
Routine post-operative esophagram Is not necessary after repair of esophageal atresia.
作者信息
Golden Jamie, Demeter Natalie E, C Lim Joanna, Ford Henri R, Upperman Jeffrey S, Gayer Christopher P
机构信息
Children's Hospital Los Angeles, Division of Pediatric Surgery, 4650 Sunset Blvd, Los Angeles, CA 90027, USA.
出版信息
Am J Surg. 2017 Apr;213(4):640-644. doi: 10.1016/j.amjsurg.2016.12.020. Epub 2016 Dec 30.
INTRODUCTION
Esophagrams are routinely performed following repair of esophageal atresia (EA) with or without tracheoesophageal fistula (TEF); however, its utility has not been validated.
METHODS
EA/TEF repair performed from 2003 to 2014 at a single pediatric hospital and from 2004 to 2014 in the Pediatric Health Information System (PHIS) database were retrospectively reviewed to determine utility of esophagrams.
RESULTS
Esophagram was performed in 99% of patients at our institution (N = 105). Clinical signs were seen prior to esophagram in patients whose leak changed clinical management. Esophagram on post-operative day ≤15 was performed in 66% of PHIS database patients (N = 3255). Esophagram did not change the incidence of chest tube placement, reoperation, or dilation. Patients who required a reoperation were less likely to have an esophagram than patients who did not require a reoperation (40.7% versus 65.7%, p < 0.001).
CONCLUSION
Our data suggest that routine esophagram is not necessary in asymptomatic patients.
引言
食管闭锁（EA）合并或不合并气管食管瘘（TEF）修复术后通常会进行食管造影；然而，其效用尚未得到验证。
方法
回顾性分析2003年至2014年在一家儿科医院以及2004年至2014年在儿科健康信息系统（PHIS）数据库中进行的EA/TEF修复手术，以确定食管造影的效用。
结果
在我们机构，99%的患者（N = 105）进行了食管造影。食管造影前，漏诊改变临床管理的患者出现了临床症状。PHIS数据库中66%的患者（N = 3255）在术后第≤15天进行了食管造影。食管造影并未改变胸管放置、再次手术或扩张的发生率。需要再次手术的患者比不需要再次手术的患者进行食管造影的可能性更小（40.7%对65.7%，p < 0.001）。
结论
我们的数据表明，无症状患者无需常规进行食管造影。
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