Congenital Esophageal Atresia 102 Cases Of Clinical Analysis

Objective: To analyze 102 cases of Congenital esophageal atresia children in our hospital, discuss the postoperative survival rate influencing factors and operative experience.Methods:We recruited 102 cases of Congenital esophageal atresia from January 2010 to January 2015.Of these patients,61 were boys and 41 were girls. According to the Gross anatomic classification, 4 were diagnosed with type Ⅰ CEA,and the other 98 were type Ⅲ CEA(31 typeⅢA and 67 type ⅢB).Combination of congenital deformity:53 cases of congenital heart disease, congenital imperforate anus in 2 cases, no anus in2 cases, congenital hypospadias in 1 case, more refers to malformation 4cases,funnel chest in 3 cases, auricle malformation in 2 cases, hip joint deformity in 1 case, gill slit edge residual in 1 case, cranial spinal dysplasia in 1 case.Analysis of postoperative death factors, compared with the operation of age, weight, operation time, distance on both ends of the atresia, small for gestational age, postoperative hypoalbuminemia,scleredema, anastomotic fistula, postoperative pneumonia aggravated, etc.the death rate: 4.9%;5 cases were because of severe pneumonia, respiratory failure and death after parents give up treatment.Compare death group and survival group. The mean surgery age was 4.40±2.30 days for death group,compared to 7.43±8.04 days for survival group;the mean weight was2.44±0.67 kg, as compared to 2.84±0.53kg; the mean operative time was140.00±32.90 minutes,compared to 121.03±42.24 minutes; the mean distance on both ends of the atresia was 1.80±1.15 cm, compared to2.12±0.78cm; the rate of postoperative hypoalbuminemia was 5 cases(100.00%)for death group,compared to 52 cases(53.61%);scleredema rate was 2 cases( 40.00%),as compared to 9 cases( 9.27%); The anastomotic leak rate was 4 cases(80.00%) versus 17 cases(17.53%),the rate of postoperative pneumonia aggravated was 5 cases(100.00%)compared to 31 cases(31.96%).Via statistics analysis,congenital heart disease, hypoalbuminemia,anastomotic fistula and scleredema significant distribution differences between the two groups, difference have statistical significance(P < 0.05), the rest of the operation of age, weight, operation time, distance on both ends of the atresia in various indicators no significant difference(P > 0.05).Result: All 102 cases received the operation, The deaths in 5 cases,Conclusion:1. Congenital esophageal atresia survival rate above 90%, close to levels in the developed countries.2. Preoperative merger of congenital cardiovascular malformations significantly reduce postoperative survival rate.3. Children with congenital esophageal atresia of death caused by hypoalbuminemia, scleredema, anastomotic fistula, postoperative pneumonia aggravated after disease mortality rates significantly higher.Hypoalbuminemia, scleredema, anastomotic fistula, postoperative pneumonia aggravated in children should be active treatment.4. Surgery of age, weight, operation time, distance on both ends of the atresia, postoperative respiratory failure does not affect postoperative survival rate.5.Surgery in children with age of death is lower than the survival group, the data on the difference is not big, no statistically significant differences, children with early surgical treatment can improve the survival rate, but the earlier surgery can improve child survival and need to continue the discussion.