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ÖZOFAGUS ATREZİLİ OLGULARLA İLGİLİ 22 YILLIK DENEYİM: (1978-2000)

Journal Name:

  • Cerrahpaşa Tıp Dergisi

Publication Year:

  • 2002

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
In this study we planned to reveal the problems and progress in the management of the esophageal atresia patients. This study consists of 231 patients with esophageal atresia, treated during the last 22 years. Patients and methods: Patients are subgrouped according to the year of diagnosis: Group I (1978- 1984), Group II (1985-1991) and Group III (1992-2000). All patients are also assessed by the prenatal history, delivery time and method, time of admission, diagnostic workup, preoperative management and timing of surgery, technique of surgery, associated anomaly, complication and mortality rate. Results: The mean weight was 2635 gr, 85% of deliveries had been in hospital and 14.7% at home, 91.1% of babies had been term and 8.9% were preterm. Prenatal polyhydramnios story had been detected in 18.8%. Among the babies with esophageal atresia 51.1% had already been diagnosed before the admission. The associated anomaly rate was 33%. Group I patients had been operated immediately, Group II patients had been stabilised and operated in semi-elective conditions, Group III patients are operated in elective conditions. Intraoperative most common complication was iatrogenic pleural opening. The most common early postoperative complication was pneumonia and atelectesia; late complication was gastroesophageal reflux. Overall mortality was 59.7% and had been found in Group I as 86.5%, in Group II 64.5% and 29.5% in Group III. Respiratory problems (respiratory stress, pneumonia) and septicemia have been the most common cause of mortality. Conclusion: This study is the largest study group published in Turkey. In this study we demonstrated, that in correlation with the development in surgical techniques, preoperative and postoperative management the complications and mortality rate decreased in esophageal atresia patients.
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Abstract (Original Language): 
Bu çalışmanın amacı kliniğimizde bakım ve tedavi gören özofagus atrezili olguları incelemek ve bu anomali ile ilgili sorunları ve gelişmeleri ortaya koymaktır. Gereç ve yöntem: Çalışmada kliniğimizde son 22 yılda tedavi ve bakımları yapılan özofagus atrezili 231 olgu geriye dönük olarak irdelendi. Olgular başvuru yıllarına göre Grup 1 (1978-1984), Grup 2 (1985-1991) ve Grup 3 (1992-2000) olmak üzere üç ana gruba ayrılarak prenatal öykü, doğum şekli ve zamanı, başvuru zaman ve şekli, tanı yöntemleri, ameliyata alınma zamanı, cerrahi teknikler, ek anomali, komplikasyonlar ve mortalite oranları açısından değerlendirildi. Bulgular: Olguların ortalama başvuru ağırl ığı 2635g, %85.3’ü hastane, %14.7’si evde doğum, % 91.1’i normal miyadında, %8.9’u erken doğum idi. Prenatal izlenen olgularda %18.8 oranında polihidroamioz saptanmıştı. Kliniğimize başvurduğunda olguların %51.1’i öntanılı idi. Ek anomali %33 oranõnda saptand ı. Grup I’deki olgular acil, Grup II ’deki olgular ise hasta stabilize edildikten sonra yarı- elektif, Grup III’deki olgular ise elektif şartlarda ameliyata alındı. En sık raslanan ameliyat sırası komplikasyon plevranın iyatrojenik açılmas ı, ameliyat sonrası erken dönem komplikasyonu atelektazi ve pnömoni, geç komplikasyon ise gastroözofagial reflü idi. Olguların ortalam %59.7’si kaybedilirken bu oran Grup I’ de %86,5 Grup II’de %64.5 Grup III’te ise %29.5 olarak tespit edildi. En sık ölüm nedeni solunum yetersizliği, pnömoni ve sepsis idi. Sonuç: Türkiyede bildirilen en geniş seri olan bu çalışma çocuklarda en sık rastlanan anomaliler arasında bulunan özofagus atrezisi ile ilgili olarak klinik bakım koşullarının dü- zelmesi ve cerrahi deneyimin artışına paralel olarak rastlanan komplikasyonlarõn ve mortalitenin incelenen dönemler içinde gittikçe azald ığını ortaya koymaktadır.
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  • 2
86-92
  • Turkish

REFERENCES

References: 

1. Okada A, Usui N, İnoue M, et al. Esophageal atresia in
Osaka: a review of 39 years experience. J Pediatr Surg
1997; 32: 1570 – 1574.
2. Myers Ma. The History of oesophageal atresia and
tracheo-oesophageal fistula - 1670-1984. Progress in
Pediatric Surgery 1986; 28: 106 - 157.
3. Teich S, Barton DP, Margaret E et al. Prognostic
classification for esophageal atresia and
tracheaoesophageal fistula: Waterstone versus Montreal.
J Pediatr Surg 1997; 32: 1075 -1080.
4. Alexander F, Johanningman J, Cincinnati LWM. Staged
repair improves outcome of high-risk premature infants
with esophageal atresia and tracheoesophageal fistula. J
Pediatr Surg 1993; 28: 151 - 154.
5. Çakmak Ö, Bernay F, Pektaş O, Baskın D. Kötü risk
grubundaki özefagus atrezisi ve trakeo özofageal fistüllü
hastalarda transabdominal yoldan fistülün kapatılması.
Ped Cer Der 1989; 3: 15 - 19.
6. Depaepe A, Dolk H, Lechat MF. The epidemioogy of
tracheo-oesophageal fistula and oesophageal atresia in
Europe. Archives Disease In Childhood 1993; 68: 743-
748.
7. Goh DW, Brereton RJ. Success and failure with neonatal
tracheo-osephageal anomalies. Br J Surg 1991; 78: 834 -
837.
8. Ein SH, Shandling B, Wesson D, Filler RM. Esophageal
atresia with distal tracheoesophageal fistul: Associated
anomalies and prognosis in the 1988s. J Pediatr Surg
1989; 24: 1055 – 1059.
9. Sharma AK, Shekhawat NS, Agrawal LD, et al.
Esophageal atresia and tracheoesophageal fistula: a
review of 25 years’ experience. Pediatr Surg Int 2000; 16:
478 – 482.
10. Spitz L, Kiely EM, Morecroft JA, Drake DP.
Oesophageal atresia: at-risk grups for the 1990’s. J
Pediatr Surg 1994; 29: 723 - 725.
11. Foker JE, Linden BC, Boyle EM, Marquardt C.
Development of a true primary repair for the full
spectrum of esophageal atresia. Ann Surg 1997; 226:
533-543.
12. Dağlı TE. Özofagus atrezisi ve trakeoözofageal fistül.
Pediatrik Cerrahi Dergisi 1987; 1: 95 - 98.
13. Erdoğan E, Celayir S, Yakar P, Yeker D. Is there a need
for thoracic drainage in esophageal atresia. 3 years
experience. First congress of Mediterranean Association
of Pediatric Surgeons (MAPS), Kahire, Mısır, Ekim
1997; 22 - 25.
14. Kõyan G, Dağlõ TE, İskit SH, ve ark. Özofagus atrezisi
primer anastomozunda Livaditis miyotomisi. Pediatrik
Cerrahi Dergisi 1996; 10: 84-87.
15. McCallin WA, Hannon RJ, Boston VE. Prophylactic
extrapleural chest drainage following repair of
esophageal atresia: Is it necessary? J Pediatr Surg 1992;
27: 561 - 564.
16. Spitz L, Kiely E, Brereton J: Esophageal atresia. Five
year experience with 148 cases. J Pediatr Surg 1987; 22:
103 - 108.
17. Al-Salman AH, Qaisaruddin S, Abu Srair H, et al.
Elective, postoperative ventilation in the management of
esophegeal atresia and tracheoesophageal fistula. Pediatr
Surg Int 1997; 12: 261 - 263.
18. Shaw K, Kay S: Revisiting the role of routine retropleural
drainage after repair of esophageal atresia with distal
tracheaoesophageal fistula. J Pediatr Surg 1999; 34:
1082 –1085.
19. Usui N, Kamata S, Ishikawa S. Anomalies of the
tracheobranchial tree in patients with esophageal atresia.
J Pediatr Surg 1996; 31: 258 - 262.

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