Through right external pleural approach of I stage surgerical treatment of type III congenital esophageal atresia

Abstract

Objective To evaluate the effects of Ⅰ stage operation through the right external pleural approach in treatment of type Ⅲ congenital esophageal atresia (CEA). Methods From January 2014 to December 2017, a total of 62 newborns with type Ⅲ CEA who were treated by Ⅰ stage operation through the right external pleural approach in Kunming Children′s Hospital were included into this study as research subjects. The surgical methods, incidences of postoperative anastomotic stenosis and anastomotic leakage, treatment outcomes were analyzed by retrospective analysis method, so as to sum up the efficacy and adverse reactions of the operation. Results The results of treatment for type Ⅲ CEA children through right external pleural approach in Ⅰ stage showed as following. ①The effective rate was 87.7% (54/62). ②Incidence of postoperative anastomotic leakage was 11.3% (7/62), incidence of postoperative anastomotic stenosis was 11.3% (7/62), and overall incidence of adverse reactions was 22.6% (14/62). ③The rate of abandoning treatment was 6.5% (4/62), and case fatality rate was 6.5% (4/62). ④After following-up of 1-42 months, the 54 cases who were discharged from hospital all recovered well. Conclusions Since the lack of control test in this study, the safety and effectiveness of Ⅰ stage operation through right external pleural approach for the treatment of type Ⅲ CEA still needs to be further studied and confirmed by a multicenter and large sample randomized controlled trial. Key words: Esophageal atresia; Congenital abnormalities; Surgical procedures, operative; External pleural approach; Anastomotic leak; Infant, newborn