کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4155586 1273751 2014 5 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Long-gap oesophageal atresia: comparison of delayed primary anastomosis and oesophageal replacement with gastric tube
ترجمه فارسی عنوان
آترزی مزاج بلند: مقایسه آنستوموز اولیه با تأخیر و جایگزینی غذا با لوله معده
کلمات کلیدی
آترزی مزوتراپی، شکاف بلند، آناستوموز اولیه اولیه را متوقف می کند، جایگزینی مری است
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پریناتولوژی (پزشکی مادر و جنین)، طب اطفال و بهداشت کودک
چکیده انگلیسی

BackgroundLong-gap oesophageal atresia (LGOA) causes significant early and long-term morbidity. We conducted a retrospective 25-year review comparing outcomes of delayed primary anastomosis versus oesophageal replacement with greater curvature gastric tube.MethodsRecords of 44 consecutive patients undergoing LGOA repair (1986–2010) were obtained from OA database with ethics approval and were analysed for complication and long-term outcomes. Analysis was conducted using Student's t-test for quantitative and Fisher exact test for qualitative data.ResultsThirty (68%) patients underwent delayed primary anastomosis and 14 (32%) had oesophageal replacement. Oesophageal replacement patients had longer gaps (mean 5.5 vertebrae, range 4–9) compared to delayed primary anastomosis (mean 3.9, range 2–6) (p = 0.004), but no difference in perioperative complications (p = 0.2) (Table 1). Oesophageal replacement had more long-term complications (86%) compared to delayed primary anastomosis (30%) (p = 0.005). Almost all patients (> 90%) experienced gastro-oesophageal reflux and 21 delayed primary anastomosis patients (70%) underwent fundoplication. 60% of delayed primary anastomosis and 64.3% of oesophageal replacement patients had continued gastrointestinal symptoms years after repair.ConclusionsOur experience indicates that LGOA can be repaired safely using both methods, with no deaths and similar perioperative risk, but high long-term morbidity mandates long-term follow-up of these patients. Delayed primary anastomosis has a better long-term outcome compared to oesophageal replacement with gastric tube.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Pediatric Surgery - Volume 49, Issue 12, December 2014, Pages 1762–1766
نویسندگان
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