Mousa Hayat, Krishnan Usha, Hassan Maheen, Dall'Oglio Luigi, Rosen Rachel, Gottrand Frédéric, Faure Christophe
Division of Pediatric Gastroenterology, Neurogastroenterology and Motility Center, Pediatric Gastroenterology, Hepatology, and Nutrition, Rady Children's Hospital, 3020 Children's Way, MC 5030, San Diego, CA, 92123, USA.
San Diego (UCSD) School of Medicine, University of California, San Diego, CA, USA.
Curr Gastroenterol Rep. 2017 Nov 25;19(12):65. doi: 10.1007/s11894-017-0605-6.
Guidelines were recently published highlighting why esophageal atresia (EA) patients are prone to complication risks, and the need for long-term follow-up. In this review, we will focus on how to investigate and treat potential complications, as well as the pros and cons of different investigative and treatment modalities, and what areas continue to need further research.
EA patients are at high risk for gastroesophageal reflux and esophageal strictures, and the sequela that result. Extraintestinal manifestations of gastroesophageal reflux disease (GERD) can appear similar to other pathologic diagnoses commonly found in EA patients, such as congenital stricture, eosinophilic esophagitis, esophageal dysmotility, tracheomalacia, recurrent fistula, aspiration, etc. Therefore, it is important to have a standardized way to monitor for these issues. pH impedance allows for detection of nonacid reflux and the height of reflux, which are important in correlating symptoms with reflux episodes. A multidisciplinary approach is beneficial in evaluating and monitoring EA patients in the long term.
近期发布的指南强调了食管闭锁(EA)患者易发生并发症风险的原因以及长期随访的必要性。在本综述中,我们将重点关注如何调查和治疗潜在并发症、不同调查和治疗方式的利弊,以及哪些领域仍需进一步研究。
EA患者发生胃食管反流和食管狭窄以及由此产生的后遗症的风险很高。胃食管反流病(GERD)的肠外表现可能与EA患者常见的其他病理诊断相似,如先天性狭窄、嗜酸性食管炎、食管动力障碍、气管软化、复发性瘘管、误吸等。因此,拥有一种标准化的方法来监测这些问题很重要。pH阻抗可检测非酸性反流和反流高度,这对于将症状与反流发作相关联很重要。多学科方法有助于长期评估和监测EA患者。