Department of Pediatric Surgery, Japan Community Healthcare Organization Kyushu Hospital, 1-8-1, Kishinoura, Yahatanishiku, Kitakyushu, 806-8501, Japan.
Department of Pediatrics, Japan Community Healthcare Organization Kyushu Hospital, Kitakyushu, Japan.
Pediatr Surg Int. 2021 Feb;37(2):261-266. doi: 10.1007/s00383-020-04805-x. Epub 2021 Jan 2.
The aim of this study was to evaluate the materials used for abdominal esophageal banding, and to evaluate the complications associated with abdominal esophageal banding.
The medical records of seven patients with esophageal atresia (EA) and tracheoesophageal fistula (TEF) who underwent abdominal esophageal banding between December 2009 and January 2020 were retrospectively reviewed.
The patients were banded with vinyl tape (n = 1), silicone tape (n = 2), polyacetal resin clips (n = 1), or an expanded polytetrafluoroethylene (ePTFE) sheet (n = 3). Banding with vinyl tape resulted in banding failure at postoperative day (POD) 89. One patient with silicone tape developed banding failure at POD 177. In the other patient, it was discovered during radical surgery that the silicone tape had slipped through the abdominal esophagus. Polyacetal resin clip banding resulted in esophageal wall perforation at POD 27. One patient banded with an ePTFE sheet underwent upper gastric transection at POD 650, while another underwent TEF resection at POD 156; in the third patient, the banding condition was maintained for more than 100 days.
Abdominal esophageal banding is useful as a palliative treatment for EA/TEF with severe associated anomalies. Surgeons should plan the next surgery depending on the patient's condition.
本研究旨在评估用于腹部食管带扎的材料，并评估与腹部食管带扎相关的并发症。
回顾性分析 2009 年 12 月至 2020 年 1 月期间 7 例食管闭锁（EA）和气管食管瘘（TEF）患者行腹部食管带扎的病历。
7 例患者分别使用乙烯基胶带（n = 1）、硅树脂胶带（n = 2）、聚缩醛树脂夹（n = 1）或膨体聚四氟乙烯（ePTFE）片（n = 3）进行带扎。术后第 89 天，1 例使用乙烯基胶带的患者发生带扎失败。1 例使用硅树脂胶带的患者在术后第 177 天发生带扎失败，在根治性手术中发现硅树脂胶带已滑过腹部食管。术后第 27 天，1 例使用聚缩醛树脂夹的患者发生食管壁穿孔。1 例使用 ePTFE 片的患者在术后第 650 天行上胃部分切除术，另 1 例在术后第 156 天行 TEF 切除术，第 3 例患者的带扎状态维持了 100 多天。
腹部食管带扎术可作为严重伴发畸形的 EA/TEF 的姑息性治疗方法。外科医生应根据患者的情况计划下一步手术。
