Ein S H, Shandling B
Division of General Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
J Pediatr Surg. 1994 Sep;29(9):1208-11. doi: 10.1016/0022-3468(94)90802-8.
This review encompasses 50 years (1942 through 1991) and 69 newborns (43 boys, 26 girls). Half the babies were premature (weighing less than 2.5 kg), and about one third had other anomalies. The procedures used in this series were late primary anastomosis (17), gastric tube reconstruction (16), staging esophagostomy and gastrostomy (13), gastric pull-up (13), early primary anastomosis (4), and colon replacement (3). Four neonates received no treatment. The most common repair in the 1940s and 1950s was the gastric pull-up; the gastric tube was the most popular in the 1960s and 1970s. Delayed primary anastomosis has been the operation of choice since the 1980s. Over the last decade, it has become apparent that primary repair is successful in three quarters of such infants if the wait is 3 months and/or the newborn weight has at least doubled. This repair appears to provide the best functional result, unless there is an anastomotic stricture. Before the 1970s, the survival rate was below 40%, but since the 1980s the rate has more than doubled, to 90% in our series, regardless of the type of repair used.
本综述涵盖了50年（1942年至1991年）的时间以及69例新生儿（43例男孩，26例女孩）。半数婴儿为早产儿（体重不足2.5千克），约三分之一伴有其他畸形。本系列所采用的手术方法包括晚期一期吻合术（17例）、胃管重建术（16例）、分期食管造口术和胃造口术（13例）、胃上提术（13例）、早期一期吻合术（4例）以及结肠替代术（3例）。4例新生儿未接受治疗。20世纪40年代和50年代最常用的修复方法是胃上提术；20世纪60年代和70年代最流行的是胃管重建术。自20世纪80年代以来，延迟一期吻合术一直是首选的手术方式。在过去十年中，显而易见的是，如果等待3个月和/或新生儿体重至少翻倍，四分之三的此类婴儿进行一期修复会取得成功。这种修复似乎能提供最佳的功能效果，除非出现吻合口狭窄。20世纪70年代以前，存活率低于40%，但自20世纪80年代以来，这一比率已增加了一倍多，在我们的系列研究中达到了90%，无论采用何种修复方式。
