Kaya Cem, Kapisiz Alparslan, Eryilmaz Sibel, Turkyilmaz Zafer, Karabulut Ramazan, Turker Leyla, Hirfanoglu Ibrahim Murat, Ergenekon Ebru, Turkyilmaz Canan, Sonmez Kaan
Department of Pediatric Surgery, Gazi University Faculty of Medicine, Ankara, Turkey.
Department of Neonatology, Gazi University Faculty of Medicine, Ankara, Turkey.
Nagoya J Med Sci. 2024 Aug;86(3):479-486. doi: 10.18999/nagjms.86.3.479.
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.
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。