ANTERIOR FLAP REPAIR OF ESOPHAGEAL ATRESIA - A 16-YEAR EVALUATION

被引:11
作者
BROWN, AK [1 ]
GOUGH, MH [1 ]
NICHOLLS, G [1 ]
TAM, PKH [1 ]
机构
[1] JOHN RADCLIFFE HOSP,OXFORD OX3 9DU,ENGLAND
关键词
ESOPHAGEAL ATRESIA; TRACHEOESOPHAGEAL FISTULA;
D O I
10.1007/BF00566488
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
The aim of the study was to evaluate the outcome of primary repair of oesophageal atresia (OA)/tracheo-oesophageal (TOF) using an anterior flap from the upper pouch to relieve tension on the anastomosis. Of 66 patients with OA/TOF managed in this institution in the period 1977-1993, only 1 (1.5%) had a colonic interposition. There were 15 (10 long-gap OA) primary repairs with an anterior flap. Median follow-up was 2 years (range 11 months-16 years). Complications included anastomotic leaks in 4 (27%), anastomotic strictures in 13 (87%): of which 2 (13.3%) required resection, gastro-oesophageal reflux in 9 (60%), of which 3 (20%) required fundoplication, recurrent TOF in 2 (14%), and oesophageal incoordination in 6 (40%). Median hospital stay was 77 days (range 18-240 days). There were 3 late deaths (12, 12, 14 months). Of 12 survivors, 8 (66.7%) achieved normal growth. In addition, 3 patients had a myotomy as well as a flap (anastomotic leak 2, stricture 3). We conclude that the anterior flap technique for repair of OA/TOF reduces the need for oesophageal replacement, There is considerable morbidity associated with its use in these high-risk patients, but a satisfactory outcome can be achieved in long-term survivors.
引用
收藏
页码:525 / 528
页数:4
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