Isolated tracheoesophageal fistula versus esophageal atresia – Early morbidity and short-term outcome. A single institution series
| Autor: | M.R. Vahdad, Claudia Roll, Matthias Nissen, Werner Finke, Grigore Cernaianu, Micha Bahr, Ralf-Bodo Tröbs |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Tracheoesophageal fistula Thoracostomy 03 medical and health sciences Postoperative Complications 0302 clinical medicine 030225 pediatrics medicine Humans Pediatrics Perinatology and Child Health Thoracotomy Single institution Esophageal Atresia Gastrostomy medicine.diagnostic_test business.industry Infant Newborn Infant Endoscopy General Medicine Perioperative medicine.disease Surgery Treatment Outcome Otorhinolaryngology 030220 oncology & carcinogenesis Atresia embryonic structures Pediatrics Perinatology and Child Health Female Morbidity business Infant Premature Tracheoesophageal Fistula |
| Zdroj: | International Journal of Pediatric Otorhinolaryngology. 94:104-111 |
| ISSN: | 0165-5876 |
| DOI: | 10.1016/j.ijporl.2017.01.022 |
| Popis: | We compared the postnatal course, morbidity and early results after repair for cases of isolated or "pure" TEF with those for cases of esophageal atresia (EA) with distal tracheoesophageal fistula (TEF).Twenty-four consecutive infants were divided into two groups: isolated TEF [TEF group] (n = 5) and EA with distal TEF [EA group] (n = 19).A high rate of prematurity (29%) and major cardiac and other surgically-relevant malformations (0.8 vs. 0.7 per infant) was found in both groups. The median age at surgery was 8 days for the TEF group vs. 1 day for the EA group (p 0.01). Most infants of both cohorts had stable acid-base and respiratory parameters at admission. Generally, tracheoscopy provided valuable information regarding the position of the TEF. Surgery for isolated TEF was performed via right cervicotomy in 4 cases and via thoracotomy in one. Postoperative thoracostomy tubes were inserted in 3 cases and one emergency gastrostomy was created for acute gastric overextension (exclusively in patients with EA). The duration of postoperative mechanical ventilation (49 vs. 113 h, p = 0.045) and the median length of stay in the pediatric surgery unit (10 vs. 20.5 days, p = 0.003) were shorter for the isolated TEF group. Four EA patients experienced severe events. Total mortality was 8% (0 out of 5 with TEF vs. 2 out of 19 with EA).Developmental delay and a high rate of morbidity were found in both groups. More complex surgery increased perioperative morbidity in cases of EA. With early recognition of isolated TEF, a less complicated course can be expected in comparison with esophageal atresia. |
| Databáze: | OpenAIRE |
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