Gawad N, Wayne C, Bass J, Nasr A
Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
Pediatr Surg Int. 2018 Sep;34(9):967-970. doi: 10.1007/s00383-018-4307-4. Epub 2018 Jul 26.
After definitive repair of esophageal atresia (EA) and tracheoesophageal fistula (TEF), a chest tube (CT) may be left in place to diagnose and conservatively treat a postoperative anastomotic leak, although its necessity is controversial. The purpose of this study was to determine if the use of a CT decreases rates of early postoperative complications after EA and TEF repair.
A retrospective chart review was performed to identify all patients with EA and TEF who underwent repair between 1985 and 2012. Univariate analysis was performed to compare patients who did or did not have a CT in terms of preoperative characteristics and postoperative outcomes.
One hundred twenty neonates were included; 69 had a CT inserted intraoperatively, while 51 did not. The two groups were similar in terms of patient characteristics. There was no statistically significant difference between the groups in terms of length of hospital stay (31 ± 12 vs. 36 ± 16 days, p = 0.5), or complication rates (13% vs. 12%, p = 0.9) for those with or without CT, respectively.
The use of a CT does not alter early postoperative complications after EA/TEF repair.
在食管闭锁（EA）和气管食管瘘（TEF）进行确定性修复后，可能会留置胸管（CT）以诊断和保守治疗术后吻合口漏，尽管其必要性存在争议。本研究的目的是确定使用胸管是否能降低EA和TEF修复术后早期并发症的发生率。
进行回顾性病历审查，以确定1985年至2012年间所有接受EA和TEF修复的患者。进行单因素分析，比较有或没有胸管的患者在术前特征和术后结果方面的情况。
纳入了120名新生儿；69名在术中插入了胸管，而51名未插入。两组在患者特征方面相似。有或没有胸管的患者在住院时间（31±12天对36±16天，p = 0.5）或并发症发生率（13%对12%，p = 0.9）方面在两组之间没有统计学上的显著差异。
使用胸管不会改变EA/TEF修复术后的早期并发症。
