Clinical Experience In Treat Long Gap Esophageal Atresia

ObjectiveReview the nearly13years treatment experience of24cases of type long gap esophageal atresia to explore a more reasonable treatment of long gap esophageal atresia.MethodsSince February2000to February2013,we have treated neonatal esophageal atresia156cases,16cases confirmed that the combination of other serious deformity after admission to give up surgery, surgical treatment of136cases in hospital, we performed end to end anastomosis of esophagus to cure type a short period of esophageal atresia of112cases,type long gap esophageal atresia24cases,10case underwent modified livaditis,9cases underwent Gough (flapper valve),5cases by Foker technology (the esophagus traction via chest outside to postpone esophageal end to end anastomosis).Results1.24case of Long gap type esophageal atresia:(1)Improved Livaditis method10cases of surgical operation, the shortest proximal and distal esophageal esophagus distance is2.5cm, the longest distance of4.0cm, the average is3.2cm. Among them4cases were anastomotic leakage, anastomotic rate was40%; esophageal stricture in2cases, stenosis rate was20%; esophageal diverticulum in1case; symptoms of gastroesophageal reflux type1case.7cases of survival, and survival rate is70%.(2)Gough method9cases of surgery, the shortest proximal and distal esophageal esophagus distance is2.7cm, the longest distance of4.0cm, the average is3.4cm. Among them3cases of anastomotic fistula, anastomotic fistula rate33.33%;4cases, anastomotic stenosis rate44.44%, esophageal diverticulum in2cases, no obvious gastroesophageal reflux.5cases of survival, survival rate55.56%.(3) Foker surgery in5cases, the shortest proximal and distal esophageal esophagus distance is2.7cm, the longest distance of4.0cm, the average pull time13days, postoperative anastomotic fistula in1case, anastomotic fistula rate20%, found no esophageal stricture of esophagus diverticulum and gastroesophageal reflux symptoms type,4cases of survival, survival rate80%.2. Short period of esophageal atresia in112cases,24cases of anastomotic fistula, anastomotic fistula was21.43%;17cases, anastomotic stenosis rate was15.18%; Diverticulum6cases; type of reflux symptoms in5cases; Live in99cases; Survival rate of88.39%.Conclusions1. Type long gap esophageal atresia is most commonly cure by modified livaditis method, Gough and Foker,Foker Success rate is slightly higher than modified livaditis method and Gough method, Less postoperative complications.2.Type a short period of esophageal atresia with esophageal end to end anastomosis method treatment, effect, overall success rate is high, up to88.39%.3. Foker method treat type long esophageal atresia effect is reliable, the results is similar with the treatment results of a short period of esophageal atresia.