World journal of pediatrics : WJP · 2014
Partial gastric pull-up in the treatment of patients with long-gap esophageal atresia.
Оценочное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Reismann Marc, Granholm Tina, Ehrén Henrik
Аннотация
BACKGROUND: This study was to analyze outcomes of long-gap esophageal atresia (LGEA) treated with partial gastric pull-up (PGP) into the thorax.
METHODS: The medical records of all children who had undergone PGP for LGEA from 1999 to 2012 were reviewed. Preoperative data, initial postoperative course, complications, time to full oral nutrition, follow-up diagnostics and nutritional status were assessed.
RESULTS: Nine children who had undergone PGP were followed up for a mean period of 6.2 ± 3.1 years. Their median gestational age was 37 ± 2 weeks, and mean birth weight 2462 ± 658 g. Eight children were primarily treated with a gastrostomy, their mean age at PGP was 11.4 ± 10.9 weeks and mean weight was 4484 ± 1966 g. Their mean operation time was 199 ± 51 minutes. Leakage was an early postoperative complication in three children, one of whom had a consecutive stricture resection. Late complications were stenosis (n=7) and gastro-esophageal reflux (n=5). The general status of the children was judged as "good" or "very good" on the last presentation. The median percentile of the body-mass-index was 25. Gastroscopy at 3.7 ± 3.2 years after the operation revealed a grade I esophagitis in two children. There was no death in this group of children.
CONCLUSIONS: Because of its high complication rate, partial gastric pull-up cannot be recommended as an alternative for the treatment of LGEA at present. A final judgment could be made on the basis of a comparative study.
METHODS: The medical records of all children who had undergone PGP for LGEA from 1999 to 2012 were reviewed. Preoperative data, initial postoperative course, complications, time to full oral nutrition, follow-up diagnostics and nutritional status were assessed.
RESULTS: Nine children who had undergone PGP were followed up for a mean period of 6.2 ± 3.1 years. Their median gestational age was 37 ± 2 weeks, and mean birth weight 2462 ± 658 g. Eight children were primarily treated with a gastrostomy, their mean age at PGP was 11.4 ± 10.9 weeks and mean weight was 4484 ± 1966 g. Their mean operation time was 199 ± 51 minutes. Leakage was an early postoperative complication in three children, one of whom had a consecutive stricture resection. Late complications were stenosis (n=7) and gastro-esophageal reflux (n=5). The general status of the children was judged as "good" or "very good" on the last presentation. The median percentile of the body-mass-index was 25. Gastroscopy at 3.7 ± 3.2 years after the operation revealed a grade I esophagitis in two children. There was no death in this group of children.
CONCLUSIONS: Because of its high complication rate, partial gastric pull-up cannot be recommended as an alternative for the treatment of LGEA at present. A final judgment could be made on the basis of a comparative study.
Предметные рубрики MeSH
Anastomosis, SurgicalChildChild, PreschoolCohort StudiesDigestive System Surgical ProceduresEsophageal AtresiaEsophagusFemaleFollow-Up StudiesGastroesophageal RefluxHumansInfantInfant, NewbornIntraoperative CareMalePostoperative ComplicationsRetrospective StudiesRisk AssessmentStomachTime FactorsTreatment Outcome