[1]冯翠竹① 张艳霞 张悦 郝献华 李龙**.胸腔镜治疗先天性食管闭锁Ⅲ型74例[J].中国微创外科杂志,2022,01(5):381-384.
　Feng Cuizhu,Zhang Yanxia*,Zhang Yue*,et al.Thoracoscopic Treatment of 74 Cases of Congenital Esophageal Atresia Type Ⅲ[J].Chinese Journal of Minimally Invasive Surgery,2022,01(5):381-384.
点击复制

胸腔镜治疗先天性食管闭锁Ⅲ型74例()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2022年5期
页码:
381-384
栏目:
临床研究
出版日期:
2022-07-21

文章信息/Info

Title:
Thoracoscopic Treatment of 74 Cases of Congenital Esophageal Atresia Type Ⅲ
作者:
冯翠竹① 张艳霞 张悦 郝献华 李龙**
(首都儿科研究所附属儿童医院普通(新生儿)外科，北京100020)
Author(s):
Feng Cuizhu;  Zhang Yanxia*;  Zhang Yue*;  et al.
*Department of Surgery, Capital Institution of Pediatrics, Beijing 100020, China
关键词:
胸腔镜; 食管闭锁; 气管食管瘘
Keywords:
Thoracoscopy; Esophageal atresia; Tracheoesophageal fistula
文献标志码:
A
摘要:
目的探讨胸腔镜技术治疗先天性食管闭锁Ⅲ型的临床疗效。方法回顾2015年1月~2020年10月74例胸腔镜治疗先天性食管闭锁Ⅲ型的临床资料，年龄(2.1±2.3)d，体重(2.66±0.50)kg。早产儿20例(27.0%)，产前检查提示食管闭锁16例(21.6%)，合并其他疾病31例(41.9%)。均行胸腔镜气管食管瘘结扎，73例食管端端吻合，1例胃造瘘。结果66例(89.2%)完成胸腔镜手术，8例中转开胸。手术时间(178.5±68.3)min，住院时间(19.7±11.7)d，住院费用(9.8±5.6)万元。术后4例放弃治疗死亡，70例(94.6%)治愈出院。术后吻合口漏9例(12.9%)，乳糜胸1例(1.4%)。术后随访1~5(2.8±1.4)年，吻合口狭窄32例(45.7%)，气管食管瘘复发3例(4.3%)，严重胃食管反流2例(2.9%)，严重气管软化1例(1.4%)。结论胸腔镜治疗先天性食管闭锁Ⅲ型安全有效。
Abstract:
ObjectiveTo investigate the clinical efficacy of thoracoscopic technique for congenital esophageal atresia type Ⅲ.MethodsClinical data of 74 cases of thoracoscopic repair of esophageal atresia from January 2015 to October 2020 were retrospectively reviewed. The age was (2.1±2.3) days old and the weight was (2.66±0.50) kg. There were 20 premature infants (27.0%). Prenatal examination showed 16 cases of esophageal atresia (21.6%) and 31 cases of other malformations (41.9%). All the children underwent thoracoscopic tracheoesophageal fistula ligation, including 73 cases of esophageal anastomosis and 1 case of gastrostomy.ResultsThere were 66 cases (89.2%) completed thoracoscopy and 8 cases transferred to thoracotomy. The operation time was (178.5±68.3) min, the length of hospital stay was (19.7±11.7) d, and the hospital expenses was (9.8±5.6)×104 yuan. Postoperatively 4 patients died after abandonment, and 70 patients (94.6%) were cured. There were 9 cases of postoperative anastomotic leakage (12.9%) and 1 case of chylothorax (1.4%). Postoperative followups for 1-5 years (mean, 2.8±1.4 years) showed 32 cases of anastomotic stenosis (45.7%), 3 cases of recurrent tracheoesophageal fistula (4.3%), 2 cases of severe gastroesophageal reflux (2.9%), and 1 case of severe tracheomalacia (1.4%).ConclusionThoracoscopic treatment of congenital esophageal atresia type Ⅲ is safe and effective.

参考文献/References:

[1]赵英敏,李龙,叶辉,等.胸腔镜在婴幼儿食管吻合术中的应用.北京医学,2007,29(3):188.
[2]王莹,马丽霜,李龙,等.胸腔镜治疗Ⅲ型食管闭锁30例分析.中国微创外科杂志,2017,17(7):581-584.
[3]张利兵,赵津亮,闫焕，等.胸腔镜Ⅲ型食管闭锁矫治的技术改良.中国微创外科杂志,2020,20(3):227-229.
[4]冯翠竹,马继东,董宁,等.胸腔镜与开胸手术治疗先天性食管闭锁并气管食管瘘的对比研究.中华小儿外科杂志,2016,37(8):589-592.
[5]van Tuyll van Serooskerken ES,Tytgat SHAJ,Verweij JW，et al.Thoracoscopic repair of esophageal atresia.J Laparoendosc Adv Surg Tech A,2021,31(10):1162-1167.
[6]Okuyama H,Saka R,Takama Y,et al.Thoracoscopic repair of esophageal atresia.Surg Today,2020,50(9):966-973.
[7]Son J,Jang Y,Kim W,et al.Thoracoscopic repair of esophageal atresia with distal tracheoesophageal fistula:is it a safe procedure in infants weighing less than 2000 g?Surg Endosc,2021,35(4):1597-1601.
[8]Fernandes E,Kusel A,Evans S,et al.Is thoracoscopic esophageal atresia repair safe in the presence of cardiac anomalies?J Pediatr Surg,2020,55(8):1511-1515.
[9]Iacona RV,Saxena AK.Thoracoscopic repair of esophageal atresia with distal tracheoesophageal fistula (type C):systematic review.Surg Laparosc Endosc Percutan Tech,2020,30(4):388-393.
[10]Thakkar H,Mullassery DM,Giuliani S,et al.Thoracoscopic oesophageal atresia/tracheooesophageal fistula (OA/TOF) repair is associated with a higher stricture rate:a single institution’s experience.Pediatr Surg Int,2021,37(3):397-401.

备注/Memo

备注/Memo:
基金项目：首都儿科研究所临床培养项目(LCPY-2021-05)**通讯作者，Email：lilong23@126.com ①(北京协和医学院研究生院，北京100005)
更新日期/Last Update: 2022-07-21