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Esophageal Atresia: Single Surgeon, Single Center Experience and Results

Year 2020, Issue: 2, 264 - 268, 01.06.2020

Mustafa Okumuş

Abstract

Objective: Esophageal atresia, one of the index cases of pediatric surgery clinics, is still of particular importance. A multidisciplinary approach, a well-equipped clinic and surgical experience are required for successful results. Although it is often done in large training hospitals, we aimed to show that satisfactory results can be obtained in any specialized hospital.Material and Method: Medical records of infants with repaired esophageal atresia from 2007 to 2017 were reviewed.Results: A total of 29 patients were included in the study. The primary anastomosis was performed in 28 of 29 patients. The median follow-up was 48.5 months. The overall survival rate was 89.6%. Incidence of anastomotic leakage was 17.8%, anastomotic stricture 50% 33.3% within the first year . Recurrent fistula and vocal cord paresis were not revealed. Trans-anastomotic stent and chest drain were routinely used. The mean gestational age was found to be 36.2±2.4 and the mean weight was 2470±687 grams. There were 4 patients with very low birth weight

Keywords

Esophageal atresia Tracheoesophageal fistula

References

  • Mortell AE, Azizkhan RG. Esophageal atresia repair with thoracotomy: the Cincinnati contemporary experience. Semin Pediatr Surg 2009;18:12–19. [CrossRef]
  • Donoso F, Kassa A-M, Gustafson E, Meurling S, Lilja HE. Outcome and management in infants with esophageal atresia - A single centre observational study. J Pediatr Surg 2016;51:1421–25. [CrossRef]
  • Sayari AJ, Tashiro J, Wang B, Perez EA, Lasko DS, Sola JE. Weekday vs. weekend repair of esophageal atresia and tracheoesophageal fistula. J Pediatr Surg 2016;51:739–742. [CrossRef]
  • Hunt RW, Perkins EA, King S. Peri-operative management of neonates with esophageal atresia and tracheo-esophageal fistula. Paediatr Respir Rev 2016;19:3–9. [CrossRef]
  • Warris A. Prophylactic antibiotics should be used in children with repaired oesphageal atresia and tracheo-oesophageal fistula: The case against. Paediatr Respir Rev 2015;18:62–63. [CrossRef]
  • Teague WJ, Karpelowsky J. Surgical Management of oesophageal atresia. Paediatr Respir Rev 2016;19:10–15. [CrossRef]
  • Conforti A, Morini F, Bagolan P. Difficult esophageal atresia: Trick and treat. Semin Pediatr Surg 2014;23:261–69. [CrossRef]
  • Dingeman C, Meyer A, Kircher G, Boemers TM, Vaske B, Till H, Ure BM. Long-term health-related quality of life after complex/or complicated esophageal atresia in adults and children registered in a German patient support group. J Pediatr Surg 2014;49:631–8. [CrossRef]
  • Gupta DK, Sharma S, Arora MK, Agarwal G, Gupta M, Grover VP. Esophageal replacement in the Neonatal period in infants with esophageal atresia and tracheoesophageal fistula. J Pediatr Surg 2007;42:1471–7. [CrossRef]
  • Gallo G, Zwaveling S, Van der Zee DC, Bax KN, de Langen ZJ, Hulscher JBF. A two-center comparative study of gastric pull-up and jejunal interposition for long gap esophageal atresia. J Pediatr Surg 2015;50;535–9. [CrossRef]
  • Kunisaki SM, Coran AG. Esophageal replacement. Semin Pediatr Surg 2017:26:105–15. [CrossRef]
  • Shanghoon L, Lee SK, Seo JM. Thoracoscopic repair of esophageal atresia with tracheoesophageal fistula: Overcoming the learning curve. J Pediatr Surg 2014;49:1570–72. [CrossRef]
  • Fusco JC, Calisto JL, Gaines BA, Malek MM. A large single-institution review of tracheoesophageal fistula with evaluation of the use of transanastomotic feeding tubes. J Pediatr Surg 2018;53:118–20. [CrossRef]
  • van der ZEE DC, Tytgat SHA, van Herwaarden MYA. Esophageal atresia and tracheoesophageal fistula. Semin Pediatr Surg 2017;26:67–71. [CrossRef]
  • Lal DR, Gadepalli SK, Downard CD, Ostlie DJ, Minneci PC, Swedler RM, et al. Challenging surgical dogma in the management of proximal esophageal atresia with distal tracheoesophageal fistula: Outcomes from the Midwest Pediatric Surgery Consortium. J Pediatr Surg 2018;53:1267–72. [CrossRef]
  • Lal DR, Gadepalli SK, Downard CD, Ostlie DJ, Minneci PC, Swedler RM, et al. Perioperative management and outcomes of esophageal atresia and traheoesophageal fistula. J Pediatr Surg 2017;52:1245– 51. [CrossRef]
  • Manfredi AM. Endoscopic management of anastomotic esophageal strictures secondary to oesophageal atresia. Gastrointest Endoscopy Clin N Am 2016;26:201–19. [CrossRef]
  • Srinivasan N, Kozarek RA. The future of esophageal endoprosthetics including the use of biodegredable materials. Tech Gastrointest Endoscopy 2014;16:92–98. [CrossRef]
  • Zhu H, Shen C, Xiao X, Dong K, Zheng S. Reoperation for anastomotic complications of esophageal atresia and tracheoesophageal fistula. J Pediatr Surg 2015;50:2012–5. [CrossRef]
  • Shawyer AC, Pemberton J, Flageole H. Post-operative management of esophageal atresia-tracheoesophageal fistula and gastroesophageal reflux: A Canadian Association of Pediatric Surgeons annual meeting survey. J Pediatr Surg 2014;49;716–19. [CrossRef]
  • Robb A, Lander A. Oesephageal atresia and tracheo-oesophageal fistula. Surgery (Oxford) 2007;25:283–6. [CrossRef]
  • Spitz L. Esophageal atresia: past, present, and future. J Pediatr Surg 1996;3:19–25. [CrossRef]
  • Wang B, Tashiro J, Allan BJ, Sola JE, Parikh PP, Hogan AR, et al. A nationwide analysis of clinical outcomes among newborns with esophageal atresia and tracheoesophageal fistulas in the United States. J Surg Res 2014;90:604–12. [CrossRef]
  • Pini Prato A, Carlucci M, Bagolan P, Gamba PG, Bernardi M, Leva E, et al. A cross-sectional nationwide survey on esophageal atresia and tracheoesophageal fistula. J Pediatr Surg 2015;50:1441–56. [CrossRef]

Özefagus Atrezisi: Tek Cerrah, Tek Merkez Deneyimi ve Sonuçları

Year 2020, Issue: 2, 264 - 268, 01.06.2020

Mustafa Okumuş

Abstract

Amaç: Çocuk cerrahisi kliniklerinin indeks vakalarından biri olan özefagus atrezisi halen ayrı bir öneme sahiptir. Başarılı sonuçlar için multidisipliner yaklaşım, donanımlı bir klinik ve cerrahi tecrübe gerekir. Sıklıkla büyük eğitim hastanelerinde tedavileri yapılsa da, donanımlı özel hastanelerde de başarılı sonuçlar alınabileceğini göstermek istedik. Materyal ve Metot: Geriye dönük gözlem olarak planlanan çalışma için, 2007 ve 2017 yılları arasında kliniğimizde özefagus atrezisi tanısı konulmuş ve tedavisi yapılmış, hastalar çalışmaya dahil edildi. Sonuçlar: Toplam 29 hasta çalışmaya dahil edildi. 29 hastanın 28’sinde primer anastomoz yapılabildi. Ortalama takip süresi 48,5 ay olarak bulundu. Tüm grupta sağkalım oranı %89,6 olarak saptandı. Anastomoz kaçağı olan hastaların oranı %17,8 olarak bulunurken, anastomoz darlığı hastaların %50’sinde saptandı. Çalışmaya dahil edilen 29 yenidoğanın 17’si erkek %58,6 ve 12’si kızdı %41,4 . Ortalama gestasyonel yaş 36,2±2,4 olarak saptanırken, ortalama ağırlık 2470±687 gram olarak bulundu. Çok düşük doğum ağırlığı

Keywords

Özefagus atrezisi Trakeoözefajiyal Fistül

References

  • Mortell AE, Azizkhan RG. Esophageal atresia repair with thoracotomy: the Cincinnati contemporary experience. Semin Pediatr Surg 2009;18:12–19. [CrossRef]
  • Donoso F, Kassa A-M, Gustafson E, Meurling S, Lilja HE. Outcome and management in infants with esophageal atresia - A single centre observational study. J Pediatr Surg 2016;51:1421–25. [CrossRef]
  • Sayari AJ, Tashiro J, Wang B, Perez EA, Lasko DS, Sola JE. Weekday vs. weekend repair of esophageal atresia and tracheoesophageal fistula. J Pediatr Surg 2016;51:739–742. [CrossRef]
  • Hunt RW, Perkins EA, King S. Peri-operative management of neonates with esophageal atresia and tracheo-esophageal fistula. Paediatr Respir Rev 2016;19:3–9. [CrossRef]
  • Warris A. Prophylactic antibiotics should be used in children with repaired oesphageal atresia and tracheo-oesophageal fistula: The case against. Paediatr Respir Rev 2015;18:62–63. [CrossRef]
  • Teague WJ, Karpelowsky J. Surgical Management of oesophageal atresia. Paediatr Respir Rev 2016;19:10–15. [CrossRef]
  • Conforti A, Morini F, Bagolan P. Difficult esophageal atresia: Trick and treat. Semin Pediatr Surg 2014;23:261–69. [CrossRef]
  • Dingeman C, Meyer A, Kircher G, Boemers TM, Vaske B, Till H, Ure BM. Long-term health-related quality of life after complex/or complicated esophageal atresia in adults and children registered in a German patient support group. J Pediatr Surg 2014;49:631–8. [CrossRef]
  • Gupta DK, Sharma S, Arora MK, Agarwal G, Gupta M, Grover VP. Esophageal replacement in the Neonatal period in infants with esophageal atresia and tracheoesophageal fistula. J Pediatr Surg 2007;42:1471–7. [CrossRef]
  • Gallo G, Zwaveling S, Van der Zee DC, Bax KN, de Langen ZJ, Hulscher JBF. A two-center comparative study of gastric pull-up and jejunal interposition for long gap esophageal atresia. J Pediatr Surg 2015;50;535–9. [CrossRef]
  • Kunisaki SM, Coran AG. Esophageal replacement. Semin Pediatr Surg 2017:26:105–15. [CrossRef]
  • Shanghoon L, Lee SK, Seo JM. Thoracoscopic repair of esophageal atresia with tracheoesophageal fistula: Overcoming the learning curve. J Pediatr Surg 2014;49:1570–72. [CrossRef]
  • Fusco JC, Calisto JL, Gaines BA, Malek MM. A large single-institution review of tracheoesophageal fistula with evaluation of the use of transanastomotic feeding tubes. J Pediatr Surg 2018;53:118–20. [CrossRef]
  • van der ZEE DC, Tytgat SHA, van Herwaarden MYA. Esophageal atresia and tracheoesophageal fistula. Semin Pediatr Surg 2017;26:67–71. [CrossRef]
  • Lal DR, Gadepalli SK, Downard CD, Ostlie DJ, Minneci PC, Swedler RM, et al. Challenging surgical dogma in the management of proximal esophageal atresia with distal tracheoesophageal fistula: Outcomes from the Midwest Pediatric Surgery Consortium. J Pediatr Surg 2018;53:1267–72. [CrossRef]
  • Lal DR, Gadepalli SK, Downard CD, Ostlie DJ, Minneci PC, Swedler RM, et al. Perioperative management and outcomes of esophageal atresia and traheoesophageal fistula. J Pediatr Surg 2017;52:1245– 51. [CrossRef]
  • Manfredi AM. Endoscopic management of anastomotic esophageal strictures secondary to oesophageal atresia. Gastrointest Endoscopy Clin N Am 2016;26:201–19. [CrossRef]
  • Srinivasan N, Kozarek RA. The future of esophageal endoprosthetics including the use of biodegredable materials. Tech Gastrointest Endoscopy 2014;16:92–98. [CrossRef]
  • Zhu H, Shen C, Xiao X, Dong K, Zheng S. Reoperation for anastomotic complications of esophageal atresia and tracheoesophageal fistula. J Pediatr Surg 2015;50:2012–5. [CrossRef]
  • Shawyer AC, Pemberton J, Flageole H. Post-operative management of esophageal atresia-tracheoesophageal fistula and gastroesophageal reflux: A Canadian Association of Pediatric Surgeons annual meeting survey. J Pediatr Surg 2014;49;716–19. [CrossRef]
  • Robb A, Lander A. Oesephageal atresia and tracheo-oesophageal fistula. Surgery (Oxford) 2007;25:283–6. [CrossRef]
  • Spitz L. Esophageal atresia: past, present, and future. J Pediatr Surg 1996;3:19–25. [CrossRef]
  • Wang B, Tashiro J, Allan BJ, Sola JE, Parikh PP, Hogan AR, et al. A nationwide analysis of clinical outcomes among newborns with esophageal atresia and tracheoesophageal fistulas in the United States. J Surg Res 2014;90:604–12. [CrossRef]
  • Pini Prato A, Carlucci M, Bagolan P, Gamba PG, Bernardi M, Leva E, et al. A cross-sectional nationwide survey on esophageal atresia and tracheoesophageal fistula. J Pediatr Surg 2015;50:1441–56. [CrossRef]
There are 24 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Mustafa Okumuş

Publication Date June 1, 2020
Published in Issue Year 2020Issue: 2

Cite

EndNote Okumuş M (June 1, 2020) Özefagus Atrezisi: Tek Cerrah, Tek Merkez Deneyimi ve Sonuçları. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2 264–268.