Shimizu Toru, Fenn Maccalla, Pandji Priscilla, Price Alana, Hamid Celine, Croaker David
Canberra Hospital, Yamba Dr, Garran, Canberra, ACT, 2605, Australia.
Children's Hospital at Westmead, Corner Hawkesbury Road and, Hainsworth St, Westmead, NSW, 2145, Australia.
Pediatr Surg Int. 2025 Aug 23;41(1):264. doi: 10.1007/s00383-025-06166-9.
Anastomotic stricture after trachea-oesophageal fistula/oesophageal atresia (TOF/OA) repair is a significant challenge in paediatric surgery. This study investigates the causes, risks, and the need for multiple dilatation procedures.
Data were retrospectively collected from a single centre performing surgeries on babies with TOF/OA from 1998 to 2023.
A total of 47 patients were grouped into AS (with anastomotic strictures, n = 33) and NS (no strictures, n = 14). The median birth weights were 2535 g and 2630 g, respectively. AS group had more premature infants (< 37 weeks, 52 vs 36%). In AS group, four patients had Gross Type A and 1 had Type D; all of NS group had Type C. A long gap between the proximal and distal oesophagus was observed more in AS group (9 vs 1, p < 0.05). Histopathology showed eosinophilic oesophagitis in nine patients from AS group and one from NS group. All patients in AS group underwent dilatation procedures. There were no statistical differences in outcomes related to the frequency of dilatation.
In our study, prematurity, long gap, and oesophagitis increased the possibility of anastomotic stricture. However, these factors did not influence the number of dilatation procedures.
气管食管瘘/食管闭锁（TOF/OA）修复术后吻合口狭窄是小儿外科面临的一项重大挑战。本研究调查其病因、风险以及多次扩张手术的必要性。
回顾性收集1998年至2023年在单一中心对TOF/OA患儿进行手术的相关数据。
共47例患者分为AS组（有吻合口狭窄，n = 33）和NS组（无狭窄，n = 14）。中位出生体重分别为2535 g和2630 g。AS组早产儿更多（<37周，52% vs 36%）。AS组中，4例为A Gross型，1例为D型；NS组均为C型。AS组近端和远端食管之间的长间隙更为常见（9例 vs 1例，p < 0.05）。组织病理学显示，AS组9例患者和NS组1例患者患有嗜酸性食管炎。AS组所有患者均接受了扩张手术。扩张频率相关的结果无统计学差异。
在我们的研究中，早产、长间隙和食管炎增加了吻合口狭窄的可能性。然而，这些因素并未影响扩张手术的次数。
