Neonatal Medicine

  • 제25권4호
  • /
  • Pages.186-190
  • /
  • 2018
  • /
  • 2287-9412(pISSN)
  • /
  • 2287-9803(eISSN)
대한신생아학회 (The Korean Society of Neonatology)
권호 표지
DOI QR코드

DOI QR Code

Esophageal Reconstruction with Gastric Pull-up in a Premature Infant with Type B Esophageal Atresia

  • Han, Young Mi (Division of Neonatology, Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine) ;
  • Lee, Narae (Division of Neonatology, Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine) ;
  • Byun, Shin Yun (Division of Neonatology, Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine) ;
  • Kim, Soo-Hong (Division of Pediatric Surgery, Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine) ;
  • Cho, Yong-Hoon (Division of Pediatric Surgery, Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine) ;
  • Kim, Hae-Young (Division of Pediatric Surgery, Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine)
  • 투고 : 2018.07.14
  • 심사 : 2018.09.08
  • 발행 : 2018.11.30
⟨ 이전 논문 다음 논문 ⟩

초록

Esophageal atresia (EA) with proximal tracheoesophageal fistula (TEF; gross type B) is a rare defect. Although most patients have long-gap EA, there are still no established surgical guidelines. A premature male infant with symmetric intrauterine growth retardation (birth weight, 1,616 g) was born at 35 weeks and 5 days of gestation. The initial diagnosis was pure EA (gross type A) based on failure to pass an orogastric tube and the absence of stomach gas. A "feed and grow" approach was implemented, with gastrostomy performed on postnatal day 2. A fistula was detected during bronchoscopy for recurrent pneumonia; thus, we confirmed type B EA and performed TEF excision and cervical end esophagostomy. As the infant's stomach volume was insufficient for bolus feeding after reaching a body weight of 2.5 kg, continuous tube feeding was provided through a gastrojejunal tube. On the basis of these findings, esophageal reconstruction with gastric pull-up was performed on postnatal day 141 (infant weight, 4.7 kg), and he was discharged 21 days postoperatively. At 12 months after birth, there was no catch-up growth; however, he is currently receiving a baby food diet without any complications. In patients with EA, bronchoscopy is useful for confirming TEF, whereas for those with long-gap EA with a small stomach volume, esophageal reconstruction with gastric pull-up after continuous feeding through a gastrojejunal tube is worth considering.

키워드

참고문헌

  1. Spitz L. Oesophageal atresia. Orphanet J Rare Dis 2007;2:24. https://doi.org/10.1186/1750-1172-2-24
  2. Spitz L, Kiely EM, Morecroft JA, Drake DP. Oesophageal atresia: at-risk groups for the 1990s. J Pediatr Surg 1994;29:723-5. https://doi.org/10.1016/0022-3468(94)90354-9
  3. Yagyu M, Gitter H, Richter B, Booss D. Esophageal atresia in Bremen, Germany: evaluation of preoperative risk classification in esophageal atresia. J Pediatr Surg 2000;35:584-7. https://doi.org/10.1053/jpsu.2000.0350584
  4. Sinha CK, Haider N, Marri RR, Rajimwale A, Fisher R, Nour S. Modified prognostic criteria for oesophageal atresia and tracheo-oesophageal fistula. Eur J Pediatr Surg 2007;17:153-7. https://doi.org/10.1055/s-2007-965394
  5. Chang EY, Chang HK, Han SJ, Choi SH, Hwang EH, Oh JT. Clinical characteristics and treatment of esophageal atresia: a single institutional experience. J Korean Surg Soc 2012;83:43-9. https://doi.org/10.4174/jkss.2012.83.1.43
  6. Cho SH, Oh BS, Lee DJ. End to end anastomosis of type A (long gap) esophageal atresia in 1200 gram premature baby: a case report. Korean J Thorac Cardiovasc Surg 1997;30:236-40.
  7. Lee DS, Namgung H, Yoon JS. Long gap esophageal atresia successfully treated by esophageal lengthening using external traction sutures. J Korean Assoc Pediatr Surg 2005;11:165-70. https://doi.org/10.13029/jkaps.2005.11.2.165
  8. Kim HT, Bae WJ, Jung SL, Lee JW. A case of the esophageal atresia with proximal tracheoesophageal fistula. J Korean Pediatr Soc 1998;41:861-4.
  9. Torfs CP, Curry CJ, Bateson TF. Population-based study of tracheoesophageal fistula and esophageal atresia. Teratology 1995;52:220-32. https://doi.org/10.1002/tera.1420520408
  10. Esophageal atresia and tracheoesophageal fistula. In: Martin RJ, Faranoff AA, Walsh MC, editors. Fanaroff and Martin's neonatal-perinatal medicine: diseases of the fetus and infant. 10th ed. Philadelphia: Elsevier Saunders, 2015:1395-400.
  11. Koivusalo AI, Sistonen SJ, Lindahl HG, Rintala RJ, Pakarinen MP. Long-term outcomes of oesophageal atresia without or with proximal tracheooesophageal fistula: gross types A and B. J Pediatr Surg 2017;52:1571-5. https://doi.org/10.1016/j.jpedsurg.2017.04.021
  12. Zani A, Eaton S, Hoellwarth ME, Puri P, Tovar J, Fasching G, et al. International survey on the management of esophageal atresia. Eur J Pediatr Surg 2014;24:3-8.
  13. Atzori P, Iacobelli BD, Bottero S, Spirydakis J, Laviani R, Trucchi A, et al. Preoperative tracheobronchoscopy in newborns with esophageal atresia: does it matter? J Pediatr Surg 2006;41:1054-7. https://doi.org/10.1016/j.jpedsurg.2006.01.074
  14. Waterston DJ, Carter RE, Aberdeen E. Oesophageal atresia: tracheo-oesophageal fistula. A study of survival in 218 infants. Lancet 1962;1:819-22.
  15. Poenaru D, Laberge JM, Neilson IR, Guttman FM. A new prognostic classification for esophageal atresia. Surgery 1993;113:426-32.
  16. Botero D, Lifshitz F. Intrauterine growth retardation and longterm effects on growth. Curr Opin Pediatr 1999;11:340-7. https://doi.org/10.1097/00008480-199908000-00013
  17. Neu J. The human gut microbiota in perinatology and neonatology. Semin Fetal Neonatal Med 2016;21:367. https://doi.org/10.1016/j.siny.2016.06.004
  18. Boyle EM Jr, Irwin ED, Foker JE. Primary repair of ultra-long-gap esophageal atresia: results without a lengthening procedure. Ann Thorac Surg 1994;57:576-9. https://doi.org/10.1016/0003-4975(94)90548-7
  19. Foker JE, Linden BC, Boyle EM Jr, Marquardt C. Development of a true primary repair for the full spectrum of esophageal atresia. Ann Surg 1997;226:533-41. https://doi.org/10.1097/00000658-199710000-00014
  20. Jung SL. A case of the esophageal atresia with distal tracheoesophageal fistula associated with duodenal obstrction. J Korean Soc Neonatol 1998;5:217-20.