• Journal of Chest Surgery
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• 제28권6호
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• pp.637-639
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• 1995

Congenital esophageal anomaly with or without tracheoesophageal fistula was rare congenital disease.We experienced 6 cases of congenital esophageal atresia, with tracheoesophageal fistula [5 cases and one esophageal atresia without fistula, were treated in the Department of Thoracic and Cardiovascular Surgery, Kangnam Sacred Heart Hospital, Hallym university, from May, 1992 to July, 1994. The type of four cases were upper blind pouch and lower tracheo or broncho esophageal fistula and one case H-type fistula with no esophageal atresia, and the one case was esophageal atresia without fistula. We performed modified Haight`s method, one case was primary closure with feeding gastrostomy and stomach interposition. Three were died due to respiratory failure on 7 and 9th postoperative days.Three were recovered uneventfully.

• Journal of Yeungnam Medical Science
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• 제2권1호
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• pp.253-258
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• 1985

H type의 기관식도루 특히 성인에서 발견된 경우는 아주 드물다. 최근 영남대학교 의과대학 흉부외과학교실에서는 식도폐쇄를 동반하지 않은 선천성 기관식도루 1예를 수술치험하여 양호한 성적을 얻었기에 문헌고찰과 함께 보고하는 바이다.

• 대한기관식도과학회지
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• 제6권1호
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• pp.90-95
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• 2000

Isolated(H-type) tracheoesophageal fistula without esophageal atresia occurs in approximately 4% of esophageal anomalies, and represents the least form of abnormal laryngotracheo-esophageal communication. Its symptoms such as coughing and choking The during the feeding, abdominal distension and recurrent pneumonitis usually start from birth. Diagnosis is made between 4 days to 4 years using the contrast esophagography and/or tracheoscopy. In case of diagnostic delay the postoperative mortality is not negligible and the most common cause of mortality is respitatory problems(infection, respiratory distress). So early diagnosis is essential in the newborn period with high index of suspicion. We report a case of H-type TEF in which operative repair was successful with references to recent literature.

• Clinical and Experimental Pediatrics
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• 제51권8호
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• pp.892-895
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• 2008

H-형태의 식도기관루 또는 선천 식도 폐쇄 없는 식도 기관루는 소아에서 매우 드문 형태이며, 그 임상 양상도 질환의 중등도에 따라 다양하게 나타난다. 몇몇의 성인에서 발견된 선천 식도 기관루는 이 질환이 조기 진단되기 어려움을 반영한다고 볼 수 있다. 위식도역류는 만성적인 흡인을 일으킬 수 있으며 폐흡인, 생명이 위험할 정도의 호흡기증상 또는 성장장애 등이 흔히 일으킬 수 있는 중한 합병증이다. 저자들은 통상의 치료에 반응을 보이지 않는 반복적인 폐렴과 천명을 동반하고 급성호흡곤란증후군으로까지 진행하였으며 반복된 식도조영촬영에서 심한 위식도역류와 H-형태의 식도기관루가 발견되었던 5개월 남아의 증례를 경험하였기에 이를 보고하는 바이다.

• Advances in pediatric surgery
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• 제17권2호
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• pp.154-161
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• 2011

Tracheoesophageal fistula without esophageal atresia (H-type TEF) is a congenital anomaly that is characterized by a fistula between the posterior wall of the trachea and the anterior wall of the esophagus, not accompanied by esophageal atresia. The purpose of this study is to investigate the clinical characteristics, diagnostic time, the side of cervical approach and short term result after surgery by searching medical records of patients treated for H-type TEF. The search was done at University of Ulsan, Department of Pediatric Surgery of Asan Medical Center, and the total number of patients from May 1989 to December 2010 was 9 with M:F ratio of 1:2. The median gestational age was $39^{+6}$ ($32^{+6}{\sim}41^{+0}$) wks. Seven out of nine patients were born at term and the other two were born premature. The clinical presentation was aspiration pneumonia, difficulty in feeding, chronic cough, vomiting, abdominal distension and growth retardation. The symptoms presented right after birth. The diagnosis was made with esophagography and the median time of diagnosis was 52 days of life. The majority of surgical corrections were performed within two weeks of diagnosis (median; 15d, range; 1d - 6m). Six patients had associated anomalies, and cardiac anomalies were most common. The cervical approach was utilized in all cases (right 2, left 7). Transient vocal cord palsy and minor esophageal leakage complicated two cases. Although the diagnosis of H-type TEF was difficult and often delayed, we had a good short term result. The left cervical approach was preferred.

• Advances in pediatric surgery
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• 제1권2호
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• pp.149-161
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• 1995

국내에서 처음으로 기관식도기형에 관하여 대한소아외과 학회 회원을 대상으로 조사하였다. 본 연구는 두 부분으로 구성되어 있었는데 하나는 최근 3년간 출생한 기관식도기형의 등록된 자료를 분석하여 국내의 기관식도기형의 현황 즉 발병율 처치 및 치료 결과등에 관한 총체적인 경향을 외국과 비교 분석하여 우리 자료와 구미 보고와의 차별성 및 유사성을 분석하고저 했으며, 다른 하나는 질문서(questionnaires) 분석을 토대로 11차 대한소아외과학회 학술대회에서 토의된 내용을 기초로 회원들의 식도기형의 진단 치료, 술후 관리, 합병증 등에 대한 경험과 의견을 종합하여 고안을 작성하였다.

• Advances in pediatric surgery
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• 제9권1호
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• pp.6-11
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• 2003

This study reviews 14 years' experience treating esophageal atresia with special emphasis on the clinical profile and outcome. From May 1989 to February 2003, 65 cases of esophageal atresia (EA) were treated at Asan Medical Center. Boys outnumbered girls 2.4 to 1. Prematutity and low birth weight were 27.7% and 38.5%. Esophageal atresia with distal tracheoesophageal fistula (TEF) was the most common type (87.7%), followed by pure EA and H type fistula. Forty-six patients (70.8%) had one or more associated anomalies, cardiac malformations were the most common. Duodenal atresia was found in 7 cases. There were 6 patients (9.2 %) with VATER cluster. VACTERL cluster was present in 18 patients (27.7%), one of who fulfilled the complete syndrome. Waterston group A, B and C made up 21.5%, 40.0% and 38.5% of the total group. Surgical treatment was attempted in 63 patients and deferred in 2 who had severe associated malformations. For EA with distal TEF, primary esophago esophagostomy was carried out in 51 cases, and division of TEF and gastrostomy in 4 cases and no operation in 2 cases. For pure EA, colonic graft was done in 2 after gastrostomy and esophagostomy, and esophago esophagostomy was performed in 2 after gastrostomy. Two patients with pure EA are waiting for the second operation after gastrostomy. Division of TEF was carried out in 2 cases with H type TEF. The overall survival rate was 76.9%, and survival by Waterston classification was 100% in group A, 80.8% in B and 60.0% in C. Thorough workup for associated anomalies, interdepartmental approach and more careful surgical decision and technique are required to improve the outcome of EA.