Sharma A K, Mangal D
Department of Pediatric Surgery, SMS Medical College, Jaipur, Rajasthan, India.
J Indian Assoc Pediatr Surg. 2017 Jul-Sep;22(3):187-188. doi: 10.4103/jiaps.JIAPS_220_16.
The survival of the patients with esophageal atresia an tracheo esophageal fistula is believed to be an epitome of the success of the neonatal surgery. Restoring the continuty of the food pipe by esophagus to esophagus anastomosis is the best option. Preservation of natural esophagus by delayed repair in a wide gap esophageal atresia is a preferred technique worldwide, however such a management required prolonged hospitalization and dedicated nursing care, which is often not available in most of the centres in India. Esophageal substitutes in wide gap requires multiple operations and have long term problems, so remains the last option. I use the technique of oblique anastomosis which had distrinct advantage over circular anastomosis in the management of esophageal atresia1. This techniqe helps in bridging wide gap to some extent & minimal stricture formation.
食管闭锁合并气管食管瘘患者的存活被认为是新生儿外科成功的一个缩影。通过食管对食管吻合术恢复食管的连续性是最佳选择。在长段食管闭锁中通过延迟修复保留天然食管是全球范围内首选的技术,然而这种治疗需要长期住院和专门的护理,而这在印度的大多数中心往往无法实现。长段食管闭锁使用食管替代物需要多次手术且存在长期问题,所以仍是最后的选择。我采用斜行吻合技术,该技术在食管闭锁的治疗中比圆形吻合具有明显优势。这种技术在一定程度上有助于桥接长段间隙并使狭窄形成最小化。