Stenström Pernilla, Salö Martin, Anderberg Magnus, Arnbjörnsson Einar
Department of Pediatric Surgery, Lund University and Skåne University Hospital, Lund, Sweden.
Gastroenterol Res Pract. 2018 May 20;2018:6021014. doi: 10.1155/2018/6021014. eCollection 2018.
The aim was to explore if severe congenital heart disease (CHD) influenced the need for dilatation of anastomotic strictures (AS) after the repair of esophageal atresia (EA).
A retrospective case-control study was conducted examining AS in children with EA and Gross type C. The spectra of CHD and cardiac interventions were reviewed. The frequency of dilatations of AS during the first year following EA reconstruction was compared between children with and without severe CHD requiring cardiac surgery during their first year of life. Endoscopic signs of stricture were an indication for dilatation.
Included in the follow-up for AS were 94 patients who had EA reconstructions, of whom 10 (11%) children had severe CHD requiring surgery during the first year including 19 different cardiac interventions. In total, 38 patients needed dilatation of esophageal AS, distributed as six (60%) with severe CHD and 32 (38%) without severe CHD ( = 0.31).
Severe CHD was present in 11% of children with EA. Esophageal AS developed in 60% children with concomitant CHD, but although high, it did not reach statistical difference from children without CHD (38%).
目的是探讨严重先天性心脏病（CHD）是否会影响食管闭锁（EA）修复术后吻合口狭窄（AS）扩张的必要性。
进行了一项回顾性病例对照研究，检查患有EA和C型大体畸形的儿童的AS情况。回顾了CHD的类型和心脏干预措施。比较了在生命的第一年需要进行心脏手术的重度CHD患儿和无重度CHD患儿在EA重建后第一年AS扩张的频率。内镜下狭窄迹象是扩张的指征。
94例进行EA重建的患者纳入了AS随访，其中10例（11%）患儿在第一年患有需要手术的重度CHD，包括19种不同的心脏干预措施。总共有38例患者需要扩张食管AS，其中6例（60%）患有重度CHD，32例（38%）无重度CHD（P = 0.31）。
11%的EA患儿存在重度CHD。伴有CHD的患儿中有60%发生食管AS，尽管比例较高，但与无CHD患儿（38%）相比未达到统计学差异。
