頁籤選單縮合
題名 | Primary Repair and Correction of Anastomotic Stricture in Congenital Esophageal Atresia=先天性食道閉鎖之初步修補及吻合狹窄之修正 |
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作者姓名(中文) | 吳明和; | 書刊名 | 臺灣外科醫學會雜誌 |
卷期 | 36:3 民92.05-06 |
頁次 | 頁120-124 |
分類號 | 417.6241 |
關鍵詞 | 先天性食道閉鎖; Congenital esophageal atresia; TE fistula; Anastomotic stricture; |
語文 | 英文(English) |
英文摘要 | Purpose: To evaluate the effect of mobilization of the esophageal pouch up to mid-level of the neck, oblique cut end of esophageal stumps, and one-layer anastomosis using 6-0 absorbable sutures on reducing occurrence of anastomotic stricture. Methods: Mobilization of the esophageal pouch up to mid-level of the neck, oblique cut end of esophageal stumps, and anastomosis using 6-0 absorbable sutures were conducted on 14 of 15 patients with congenital esophageal atresia and tracheoesophageal (TE) fistula. Of these 15 patients, 12 underwent primary repair, while three others were referred from other hospitals for further management of anastomotic stenosis alone (n=2) or combined with recurrent TE fistula (n=l). Two of these three referred patients underwent anastomotic revision and the other one underwent esophagojejunostomy, gastrojejunostomy, and jejunojeJunostomy. Results: All esophageal gaps up to 3 cm of these primary-repair patients could be easily approximated without myotomy after mobilization of the esophageal pouch up to mid-level of the neck and all anastomoses were delicately done. None of these 12 primary-repair newborns required gastrostomy. Esophagography revealed that all anastomoses were patent, and the diameter of the proximal esophagus was comparable to that of the distal esophagus. One patient later died of heart surgery. Among the three referred patients, the dilated proximal esophagi resulted from delayed treatment also gradually returned to normal. Conclusion: Mobilization of the esophageal pouch up to mid-level of the neck, oblique cut end of esophageal stumps, and one-layer anastomosis using 6-0 absorbable sutures can potentially prevent the occurrence of anastomotic stricture. Revision of most stenotic anastomosis can also be achieved using this maneuver. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。