亲爱的研友该休息了!由于当前在线用户较少,发布求助请尽量完整地填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!身体可是革命的本钱,早点休息,好梦!

Perioperative management and outcomes of esophageal atresia and tracheoesophageal fistula

医学 气管食管瘘 闭锁 吻合 回顾性队列研究 队列 围手术期 瘘管 儿科 外科 内科学
作者
Dave R. Lal,Samir K. Gadepalli,Cynthia D. Downard,Daniel J. Ostlie,Peter C. Minneci,Ruth M. Swedler,Thomas Chelius,Laura D. Cassidy,Cooper T. Rapp,Katherine J. Deans,Mary E. Fallat,S. Maria E. Finnell,Michael A. Helmrath,Ronald B. Hirschl,Rashmi Kabre,Charles M. Leys,Grace Z. Mak,Jessica Raque,Frederick J. Rescorla,Jacqueline M. Saito,Shawn D. St. Peter,Daniel von Allmen,Brad W. Warner,Thomas T. Sato
出处
期刊:Journal of Pediatric Surgery [Elsevier BV]
卷期号:52 (8): 1245-1251 被引量:151
标识
DOI:10.1016/j.jpedsurg.2016.11.046
摘要

Background/Purpose Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a rare congenital anomaly lacking contemporary data detailing patient demographics, medical/surgical management and outcomes. Substantial variation in the care of infants with EA/TEF may affect both short- and long-term outcomes. The purpose of this study was to characterize the demographics, management strategies and outcomes in a contemporary multi-institutional cohort of infants diagnosed with EA/TEF to identify potential areas for standardization of care. Methods A multi-institutional retrospective cohort study of infants with EA/TEF treated at 11 children's hospitals between 2009 and 2014 was performed. Over the 5 year period, 396 cases were identified in the 11 centers (7 ± 5 per center per year). All infants with a diagnosis of EA/TEF made within 30 days of life who had surgical repair of their defect defined as esophageal reconstruction with or without ligation of TEF within the first six months of life were included. Demographic, operative, and outcome data were collected and analyzed to detect associations between variables. Results Prenatal suspicion or diagnosis of EA/TEF was present in 53 (13%). The most common anatomy was proximal EA with distal TEF (n = 335; 85%) followed by pure EA (n = 27; 7%). Clinically significant congenital heart disease (CHD) was present in 137 (35%). Mortality was 7.5% and significantly associated with CHD (p < 0.0001). Postoperative morbidity occurred in 62% of the population, including 165 (42%) cases with anastomotic stricture requiring intervention, anastomotic leak in 89 (23%), vocal cord paresis/paralysis in 26 (7%), recurrent fistula in 19 (5%), and anastomotic dehiscence in 9 (2%). Substantial variation in practice across our institutions existed: bronchoscopy prior to repair was performed in 64% of cases (range: 0%–100%); proximal pouch contrast study in 21% (0%–69%); use of interposing material between the esophageal and tracheal suture lines in 38% (0%–69%); perioperative antibiotics ≥24 h in 69% (36%–97%); and transanastomotic tubes in 73% (21%–100%). Conclusion Contemporary treatment of EA/TEF is characterized by substantial variation in perioperative management and considerable postoperative morbidity and mortality. Future studies are planned to establish best practices and clinical care guidelines for infants with EA/TEF. Level of Evidence Type of study: Treatment study. Level IV.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
Hcc完成签到 ,获得积分10
3秒前
11秒前
风登楼发布了新的文献求助10
16秒前
学术小白完成签到,获得积分10
18秒前
21秒前
婼汐完成签到 ,获得积分10
23秒前
24秒前
量子星尘发布了新的文献求助10
31秒前
Owen应助瘦瘦的寒珊采纳,获得10
45秒前
46秒前
活泼的冬寒完成签到,获得积分10
50秒前
59秒前
瘦瘦的寒珊完成签到,获得积分10
59秒前
有魅力听枫完成签到,获得积分10
1分钟前
1分钟前
叶梓轩完成签到 ,获得积分10
1分钟前
wanci应助如意的书桃采纳,获得30
1分钟前
李健的粉丝团团长应助gyh采纳,获得10
1分钟前
Owen应助风登楼采纳,获得10
1分钟前
1分钟前
xiao发布了新的文献求助10
1分钟前
孙孙应助图治采纳,获得10
1分钟前
风登楼完成签到,获得积分10
1分钟前
香蕉觅云应助xiao采纳,获得10
1分钟前
我啊完成签到 ,获得积分10
1分钟前
木木完成签到 ,获得积分10
1分钟前
开心的火龙果完成签到,获得积分10
1分钟前
西红柿有股番茄味完成签到,获得积分10
1分钟前
量子星尘发布了新的文献求助10
1分钟前
zz完成签到,获得积分10
1分钟前
2分钟前
研友_VZG7GZ应助polaris采纳,获得10
2分钟前
2分钟前
手拿把掐吴完成签到 ,获得积分10
2分钟前
polaris发布了新的文献求助10
2分钟前
2分钟前
Alex发布了新的文献求助10
2分钟前
Jasper应助polaris采纳,获得10
2分钟前
2分钟前
2分钟前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 700
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3976643
求助须知:如何正确求助?哪些是违规求助? 3520735
关于积分的说明 11204613
捐赠科研通 3257484
什么是DOI,文献DOI怎么找? 1798716
邀请新用户注册赠送积分活动 877897
科研通“疑难数据库(出版商)”最低求助积分说明 806613