OUR EXPERIENCE OF TREATMENT OF ESOPHAGEAL ATRESIA IN CHILDREN
Abstract
Background. Esophageal atresia is a malformation which is characterized by oesophageal obstruction. Objective. To study the results of treatment of esophageal atresia in the pediatric surgery clinic and to estimate the efficacy of the offered techniques.
Materials and methods. We carried out a retrospective (1992-2004) and prospective analysis (2005-2017) of the results of surgical treatment of patients with congenital oesophageal obstruction who received treatment in our clinic.
Results. The number of cases of anastomotic leak has decreased from 47.3% to 7.7%. The quantity of esophageal stenoses was 25.9% and there were no recurrences of fistula and bleeding. Postoperative lethality has decreased from 55.2% to7.7%.
Conclusion. In esophagel atresia with a diastasis between esophageal segments measuring 1.5-2.0 cm, the use of the method of fixation of segments of esophagus to a prevertebral fascia allows to impose primary or delayed anastomosis without tension which permits to avoid esophagoplasty and reduce disability. In esophagel atresia with a greater diastasis between esophageal segments the use of the method of proximal gullet bougienage with catheters for providing the feeding of newborns 3-4 times a day followed by serial check X-rays taken every 3 weeks allows to reduce diastasis and to impose delayed esophagoesophageal anastomosis. The developed method of treatment of TEF allows to avoid deformation of trachea and TEF recurrence. Application of the developed methods in treatment of patients with atresia allowed us to reduce the number of postoperative complications: anastomotic leak – from 47.3% to 7.7%, TEF recurrence – from 7.8% to 0, bleeding – from 15,7% to 0.
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