Kim Soo-Hong, Kim Hyun-Young, Jung Sung-Eun, Lee Seong-Cheol, Park Kwi-Won
Department of Pediatric Surgery, Pusan National University Children's Hospital, Yangsan, Korea.
Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea.
Pediatr Gastroenterol Hepatol Nutr. 2017 Jun;20(2):79-86. doi: 10.5223/pghn.2017.20.2.79. Epub 2017 Jun 28.
Congenital esophageal atresia (CES) is a rare congenital disease. The severity of symptoms is variable; thus, diagnosis is difficult and tends to be delayed. CES is frequently accompanied by esophageal atresia (EA) with/without tracheoesophageal fistula (TEF). We investigated the characteristics of CES by reviewing our experience with CES patients and researched the differences between CES with EA-TEF and isolated CES.
A total of 31 patients underwent operations for CES were reviewed retrospectively. The patients were divided into two groups according to the association with EA-TEF, and compared the differences.
Sixteen boys and 15 girls were included. The mean age at symptom onset was 8 months old, and the mean age at diagnosis was 21 months old. Nine patients with EA-TEF were included group A, whereas the other 22 patients were assigned to group B. There were no differences in sex, gestational age, associated anomalies and pathologic results between the groups. In group A, the age at diagnosis and age at surgery were younger than in group B despite the age at symptom occurrence being similar. Postoperative complications occurred only in group A.
In this study, symptoms occurred during the weaning period, and vomiting was the most frequent symptom. CES patients with EA-TEF tended to be diagnosed and treated earlier despite the age at symptom occurrence being similar. CES patients with EA-TEF had more postoperative complications; therefore, greater attention should be paid during the postoperative period.
先天性食管闭锁(CES)是一种罕见的先天性疾病。症状的严重程度各不相同,因此诊断困难且往往延迟。CES常伴有食管闭锁(EA)合并或不合并气管食管瘘(TEF)。我们通过回顾CES患者的经验来研究CES的特征,并研究合并EA-TEF的CES与孤立性CES之间的差异。
回顾性分析31例行CES手术的患者。根据是否合并EA-TEF将患者分为两组,并比较差异。
纳入16例男孩和15例女孩。症状出现的平均年龄为8个月,诊断时的平均年龄为21个月。9例合并EA-TEF的患者纳入A组,其余22例患者分配到B组。两组在性别、孕周、合并畸形和病理结果方面无差异。在A组中,尽管症状出现的年龄相似,但诊断年龄和手术年龄比B组小。术后并发症仅发生在A组。
在本研究中,症状出现在断奶期,呕吐是最常见的症状。合并EA-TEF的CES患者尽管症状出现的年龄相似,但往往诊断和治疗较早。合并EA-TEF的CES患者术后并发症更多;因此,术后应给予更多关注。