新生儿Ⅰ期胃代食管术治疗Ⅲa型食管闭锁的疗效观察

目的:探讨Ⅰ期胃代食管术治疗Ⅲa型食管闭锁的疗效。方法:对2008年3月至2013年6月我院采用Ⅰ期胃代食管术治疗的8例Ⅲa型食管闭锁进行回顾性分析。其中男6例,女2例,食管两盲端距离均大于3 cm。结果:所有患儿均顺利完成手术。6例治愈出院,1例死亡,1例家长放弃治疗。术后5例有严重肺炎,近期吻合口瘘2例。随访6个月至5年,吻合口狭窄2例,均行食管扩张术治愈,轻度胃食管反流4例,均未行抗反流手术,采用少量多餐及体味喂养治疗后症状缓解。结论:新生儿期采用Ⅰ期胃代食管术治疗Ⅲa型食管闭锁临床可行,避免了分期手术,缩短了治疗周期,有助于提高治愈率。

Observation on the Clinical Efficacy of One-Stage Gastric Transposition in Type IIIA Esophageal Atresia

Objective:To explore the application and efficacy of one-stage gastric transposition in type IIIA esophageal atresia.Methods:8 patients of type IIIA esophageal atresia who received one-stage gastric transposition treatment fromMarch 2008 to June 2013 were analyzed. 6 male and 2 female babies were included in the study. And the distance of esophageal ends is greater than 3cm.Results:All procedures were completed, 6 cases were cured, 1 case died and 1 case refused further treatment after operation. 5 cases developed pneumonia postoperatively, and 2 cases had signs of stoma leakage. All cases were followed up for 6 months to 5 years. 3 cases had anastomotic stricture and they were cured by balloon dilation. 2 cases had mild gastroesophageal reflux but no anti-reflux procedure was needed. And gastroesophageal reflux symptoms were improved by smaller meals and appreciate the feeding treatment.Conclusion:One-stage gastric transposition is feasible and acceptable in treating type IIIA esophageal atresia in neonates, and it can avoid staging operation, shorten the treatment period, and help to improve the cure rate.