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我们在使用自体食管进行修复方面的经验,例如在治疗长段食管闭锁患者时采用的福克(Foker)法和加齐(Gazi)法。

Our experience in repairs using the native esophagus such as the Foker and Gazi methods in the management of patients with long-gap esophageal atresia.

作者信息

Kaya Cem, Kapisiz Alparslan, Eryilmaz Sibel, Turkyilmaz Zafer, Karabulut Ramazan, Turker Leyla, Hirfanoglu Ibrahim Murat, Ergenekon Ebru, Turkyilmaz Canan, Sonmez Kaan

机构信息

Department of Pediatric Surgery, Gazi University Faculty of Medicine, Ankara, Turkey.

Department of Neonatology, Gazi University Faculty of Medicine, Ankara, Turkey.

出版信息

Nagoya J Med Sci. 2024 Aug;86(3):479-486. doi: 10.18999/nagjms.86.3.479.

DOI:10.18999/nagjms.86.3.479
PMID:39355365
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11439611/
Abstract

This study aimed to share our experience with infants with repaired long-gap esophageal atresia (LGEA) using the native esophagus and Foker and Gazi methods. We retrospectively analyzed the medical records of 10 patients with LGEA (six with pure esophageal atresia [EA], and four with distal trachea-esophageal fistula [TEF] + EA). The mean length between the esophageal pouches was 5.9 cm (4-9 cm). Five Foker methods, three Gazi methods, and two delayed primary repairs after a daily bougie were performed an average of 19.3 days after the first surgery and 26.4 days after the final esophageal anastomosis. For the Foker technique, it was 36.1 days. Their first oral intake was 10.2 days, and their transition to full enteral food was 26.2 days. An esophageal leak was detected in six patients. Fundoplication and dilatations were performed for three and four patients, respectively. For good results, LGEA patients should be operated on at least under the supervision of an experienced surgeon in specialized centers, and the team should be familiar with the techniques for using the native esophagus.

摘要

本研究旨在分享我们使用自体食管以及福克(Foker)法和加齐(Gazi)法治疗长段食管闭锁(LGEA)修复术后婴儿的经验。我们回顾性分析了10例LGEA患者的病历(6例为单纯食管闭锁[EA],4例为远端气管食管瘘[TEF]+EA)。食管盲端之间的平均长度为5.9厘米(4 - 9厘米)。5例采用福克法、3例采用加齐法以及2例在每日扩张探条扩张后进行延迟一期修复,平均在首次手术后19.3天以及最终食管吻合术后26.4天进行。对于福克技术,时间为36.1天。他们首次经口进食时间为10.2天,过渡到完全肠内营养时间为26.2天。6例患者检测到食管漏。分别对3例和4例患者进行了胃底折叠术和扩张术。为取得良好效果,LGEA患者应至少在专业中心经验丰富的外科医生监督下进行手术,并且团队应熟悉使用自体食管的技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86aa/11439611/04e9901b5fc0/2186-3326-86-0479-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86aa/11439611/04e9901b5fc0/2186-3326-86-0479-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86aa/11439611/04e9901b5fc0/2186-3326-86-0479-g001.jpg

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本文引用的文献

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Delayed primary repair in 100 infants with isolated long-gap esophageal atresia: A nationwide analysis of children's hospitals.100 例单纯长段食管闭锁婴儿延迟一期修复:儿童医院的全国性分析。
Surgery. 2023 Jun;173(6):1447-1451. doi: 10.1016/j.surg.2023.03.005. Epub 2023 Apr 10.
2
Delayed primary anastomosis for repair of long-gap esophageal atresia: technique revisited.延迟一期吻合术修复长段食管闭锁:技术再探讨。
Pediatr Surg Int. 2022 Dec 8;39(1):40. doi: 10.1007/s00383-022-05317-6.
3
A single centre experience using internal traction sutures in managing long gap oesophageal atresia.
单中心使用内置牵引缝线治疗长段食管闭锁的经验
J Pediatr Surg. 2022 Nov;57(11):516-519. doi: 10.1016/j.jpedsurg.2022.05.008. Epub 2022 May 14.
4
Contemporary outcomes of the Foker process and evolution of treatment algorithms for long-gap esophageal atresia.福克(Foker)手术的当代结果和长段食管闭锁治疗方案的演变。
J Pediatr Surg. 2021 Dec;56(12):2180-2191. doi: 10.1016/j.jpedsurg.2021.02.054. Epub 2021 Feb 26.
5
Outcomes for Correction of Long-Gap Esophageal Atresia: A 22-Year Experience.长段食管闭锁矫正术的治疗结果:22年经验总结
J Surg Res. 2020 Jul;251:47-52. doi: 10.1016/j.jss.2020.01.020. Epub 2020 Feb 26.
6
Surgical treatment and major complications Within the first year of life in newborns with long-gap esophageal atresia gross type A and B - a systematic review.新生儿长段型食管闭锁 gross 型 A 和 B 外科治疗及主要并发症:系统评价。
J Pediatr Surg. 2019 Nov;54(11):2242-2249. doi: 10.1016/j.jpedsurg.2019.06.017. Epub 2019 Jun 27.
7
Management of long gap esophageal atresia: A systematic review and evidence-based guidelines from the APSA Outcomes and Evidence Based Practice Committee.长段食管闭锁的管理:来自美国小儿外科学会(APSA)结果与循证实践委员会的系统评价和循证指南
J Pediatr Surg. 2019 Apr;54(4):675-687. doi: 10.1016/j.jpedsurg.2018.12.019. Epub 2019 Feb 7.
8
Position Paper of INoEA Working Group on Long-Gap Esophageal Atresia: For Better Care.国际食管闭锁与食管气管瘘研究协会(INoEA)长段食管闭锁工作组立场文件:为了更好的治疗。
Front Pediatr. 2017 Mar 31;5:63. doi: 10.3389/fped.2017.00063. eCollection 2017.
9
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World J Pediatr. 2016 May;12(2):250-1. doi: 10.1007/s12519-016-0010-5.
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