Pedersen J C, Klein R L, Andrews D A
Department of Pediatric Surgery, Children's Hospital Medical Center, Akron, OH, USA.
J Pediatr Surg. 1996 Sep;31(9):1233-5. doi: 10.1016/s0022-3468(96)90240-7.
Long gap esophageal atresia occurs in approximately 5% of patients with tracheoesophageal anomalies. A small group of such patients have a rudimentary or diverticular distal esophagus that is not amenable to primary repair. These children usually require staged procedures and esophageal replacement using other parts of the intestinal tract. To circumvent the morbidity and delayed repair associated with cervical esophagostomy, colon interposition, or delayed gastric tube interposition, the authors propose the use of a primary gastric tube for early establishment of esophageal continuity in the neonate. Three cases of early esophageal replacement using a gastric tube are described. All three patients were born prematurely, with comorbid conditions, and had a rudimentary distal esophagus. The results of the operation were successful. The authors believe that primary repair of the esophagus, when possible, is the gold standard.
长段食管闭锁约占气管食管畸形患者的5%。一小部分此类患者的远端食管发育不全或呈憩室样，无法进行一期修复。这些患儿通常需要分期手术，并使用肠道其他部位进行食管替代。为避免与颈部食管造口术、结肠间置术或延迟胃管间置术相关的发病率和延迟修复，作者建议在新生儿期使用一期胃管尽早建立食管连续性。本文描述了3例使用胃管进行早期食管替代的病例。所有3例患者均为早产儿，伴有合并症，且远端食管发育不全。手术结果成功。作者认为，在可能的情况下，食管一期修复是金标准。
