Woodward John M, Corujo Avila Patricia, Mathew Bobby, Bass Kathryn D, Ham Rd P Benson
University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Department of Surgery, 100 High Street, Buffalo, NY 14215, United States.
Division of Pediatric Surgery, John R. Oishei Children's Hospital, 100 High Street, Buffalo NY 14215, United States.
J Surg Case Rep. 2025 May 29;2025(5):rjaf333. doi: 10.1093/jscr/rjaf333. eCollection 2025 May.
Congenital diaphragmatic hernia (CDH) associated with esophageal atresia (EA) and tracheoesophageal fistula (TEF) is a rare and often fatal combination with reported survival rates of 6%-26%. We aim to analyze the literature on left sided CDH with EA and TEF and report our experience, hypothesizing that delaying right chest approach for EA/TEF repair improves outcomes. We report a case of a 1.5 kg 32-week patient who survived a staged approach of initial CDH repair and abdominal control of TEF with gastrostomy to water seal and vessel loop encircling the gastroesophageal junction followed by EA/TEF repair at 18 days of life. This case report and review of the literature highlights the benefit of a staged surgical approach for left CDH, EA, and TEF; initially proceeding with CDH repair and abdominal control of the TEF first, followed by EA/TEF repair once the patient stabilizes.
先天性膈疝（CDH）合并食管闭锁（EA）和气管食管瘘（TEF）是一种罕见且通常致命的组合，报告的生存率为6%-26%。我们旨在分析关于左侧CDH合并EA和TEF的文献并报告我们的经验，推测延迟右侧开胸进行EA/TEF修复可改善预后。我们报告一例1.5千克、32周龄的患者，该患者在接受了分期手术，即先进行CDH修复并通过胃造口术对TEF进行腹部控制，以水封并使用血管环环绕胃食管交界处，然后在出生18天时进行EA/TEF修复后存活。本病例报告及文献综述强调了对左侧CDH、EA和TEF采用分期手术方法的益处；首先进行CDH修复并对TEF进行腹部控制，待患者稳定后再进行EA/TEF修复。
