• Home
  • NEW DAY MEDICINE
  • 4 (66) 2024
  • 16 -4 (66) 2024 - Shchapov N.F., Ekimovskaya E.V. - DIAGNOSIS AND TREATMENT OF ATYPICAL FORMS OF ESOPHAGEAL ATRESIA IN NEWBORNS

16 -4 (66) 2024 - Shchapov N.F., Ekimovskaya E.V. - DIAGNOSIS AND TREATMENT OF ATYPICAL FORMS OF ESOPHAGEAL ATRESIA IN NEWBORNS

DIAGNOSIS AND TREATMENT OF ATYPICAL FORMS OF ESOPHAGEAL ATRESIA IN NEWBORNS

Shchapov N.F. JSC "Ilyinskaya Hospital", 143421, Russia

Ekimovskaya E.V. FGAU "National Medical Research Center for Children's Health" Ministry of Health of Russia

Kulikov D.V. JSC "Ilyinskaya Hospital", 143421, Russia

Shatova S.M. Pediatric department, MEDSI polyclinic in Kotelniki, 140055, Russia

Sergeeva S.V. Scientific and Practical Center for Specialized Medical Care for Children named after V.F. Voino-Yasinetskogo, 119620, Russia

Resume

Esophageal atresia (EA) is a complex congenital defect that requires an integrated approach to treatment and accurate diagnosis. The defect is characterized by a variety of forms and requires individualized surgical intervention, especially with rare anomalies, which can significantly affect the strategy and tactics of treatment. The authors analyzed the features of clinical manifestations, diagnosis and treatment of rare forms of AP to optimize surgical approaches and improve outcomes for patients. Among 43 cases of AP operated on from 2018 to 2021, we identified three patients with atypical anatomy of the defect: AP in combination with tubular duplication of the esophagus, right-located aortic arch. We performed thoracoscopic plastic surgery on these children using a technique that differed from the standard one for us. Also in our practice, we encountered transient functional stenosis of the esophagus, as a result not of a developmental defect, but as a consequence of intrapartum hypoxia.There were no intraoperative complications. In the postoperative period, both patients developed severe aspiration pneumonia. The first child died on the 7th day after surgery, despite complex treatment. In addition to infectious complications, the second child developed anastomotic stenosis. After correcting all identified complications, the condition was stabilized and the child was discharged home. In a child with functional stenosis, with tube feeding, the period of recovery of the nervous system of the esophagus went smoothly; no further surgical treatment was required. Thus, accurate and timely diagnosis allows you to accurately determine the type of atresia and the presence of associated defects. This provides the possibility of effective and safe treatment, and is key to achieving positive clinical results.

Keywords: Esophageal atresia, tracheoesophageal fistula, thoracoscopy, non-standard forms, functional esophageal stenosis.

First page

91

Last page

100

For citation: Shchapov N.F., Ekimovskaya E.V., Kulikov D.V., Shatova S.M., Sergeeva S.V. - DIAGNOSIS AND TREATMENT OF ATYPICAL FORMS OF ESOPHAGEAL ATRESIA IN NEWBORNS//New Day in Medicine 4(66)2024 91-100 https://newdayworldmedicine.com/en/article/3758

List of References

  1. Van der Zee DC, Bax NM. Thoracoscopic repair of esophageal atresia with distal fistula. Surg Endosc.2003;17(7):1065-1067. doi:10.1007/s00464-002-9177-z
  2. Ротенберг С., Козлов Ю.А. Атрезия пищевода — современное состояние проблемы (Обзор литературы по базе PubMed). // Российский вестник детской хирургии, анестезиологии и реаниматологии. 2020: 10(3): 327–338. https://doi.org/10.17816/psaic667
  3. Атрезия пищевода у детей. Клинические рекомендации Министерства здравоохранения Российской Федерации, 2016 Атрезия пищевода у детей // Министерство здравоохранения РФ. — 2016.
  4. Shchapov NF, Ekimovskaya EV, Kulikov DV et al. Treatment of congenital duodenal obstruction: from open to laparoscopic approach for duodeno-duodenal anastomosis. // Medical Research Archives, [S.l.], v. 11, n. 7.2, aug. 2023. doi: https://doi.org/10.18103/mra.v11i7.2.4139.
  5. Gross RE. The Surgery of Infancy and Childhood. Philadelphia: WB Saunders; 1953.
  6. Merei JM, Hutson JM. Embryogenesis of tracheo esophageal anomalies: a review. // Pediatr Surg Int. 2002;18(5-6):319-326. doi:10.1007/s00383-002-0751-1
  7. Ein SH, Palder SB, Filler RM. Babies with esophageal and duodenal atresia: a 30-year review of a multifaceted problem. // J Pediatr Surg. 2006;41(3):530-532. doi:10.1016/j.jpedsurg.2005.11.061
  8. Brzački V, Mladenović B, Jeremić L, et al. Congenital esophageal stenosis: a rare malformation of the foregut. // Nagoya J Med Sci. 2019;81(4):535-547. doi:10.18999/nagjms.81.4.535
  9. Козлов Ю.А., Новожилов В.А., Вебер И.Н., Распутин А.А., Ковальков К.А., Чубко Д.М., Барадиева П.Ж., Звонков Д.А., Тимофеев А.Д., Очиров Ч.Б., Распутина Н.В., Ус Г.П., Кузнецова Н.Н., Кононенко М.И. Лечение пациентов с атрезией пищевода и правой дугой аорты. // Детская хирургия. 2018; 22(2): 96-98. DOI: http//dx.doi.org/10.18821/1560-9510-2018-22-2-96-98
  10. Разумовский А.Ю., Рачков В.Е., Щапов Н.Ф. Перспективы применения экстраплеврального доступа при торакоскопии у детей, // Детская хирургия, 2012 №1, с. 38 -42

    file

    download