Parolini Filippo, Bulotta Anna Lavinia, Battaglia Sonia, Alberti Daniele
Department of Pediatric Surgery, "Spedali Civili" Children's Hospital.
Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Pediatric Health Med Ther. 2017 Jan 18;8:1-7. doi: 10.2147/PHMT.S106643. eCollection 2017.
Esophageal atresia remains one of the most challenging congenital anomalies of the newborn. In recent years, because of the advances in prenatal diagnosis, neonatal critical care, and surgical procedures, overall outcomes have improved substantially, including for premature children. Nowadays, most of the research is focused on medium- and long-term morbidity, with particular reference to respiratory and gastroesophageal problems; the high frequency of late sequelae in esophageal atresia warrants regular and multidisciplinary checkups throughout adulthood. Surprisingly, there are few studies on the impact of prenatal diagnosis and there is continuing debate over the prenatal and preoperative management of these complex patients. In this review, we analyze the literature surrounding current knowledge on the management of newborns affected by esophageal atresia, focusing on prenatal management and preoperative assessment.
食管闭锁仍然是新生儿最具挑战性的先天性畸形之一。近年来,由于产前诊断、新生儿重症监护和外科手术的进展,总体预后有了显著改善,包括早产儿。如今,大多数研究集中在中长期发病率,特别是呼吸和胃食管问题;食管闭锁晚期后遗症的高发生率需要在整个成年期进行定期和多学科检查。令人惊讶的是,关于产前诊断影响的研究很少,对于这些复杂患者的产前和术前管理也存在持续的争论。在这篇综述中,我们分析了围绕食管闭锁新生儿管理的现有知识的文献,重点关注产前管理和术前评估。