EN
TÜRKÇE
Poster - 43
Long-term outcome of esophageal atresia and distal tracheoesophageal fistula repaired through minimal and extensive mobilization of upper pouch
D Yadav*, SK Acharya**, V Jain*, A Dhua*, P Goel*, S Agarwala*
*All India Institute of Medical Sciences, New DElhi
**VMMC and Safdarjang Hospital, New Delhi
Aim- To evaluate the long-term outcome after primary repair of esophageal atresia with distal tracheoesophageal (EA-DTEF) operated through minimal and extensive mobilization of upper pouch.
Materials and Methods- a retrospective analysis of consecutive cases of EA-TEF from Jun 2012 through Jun 2020. Study parameters analyzed were demographics, associated anomalies, dysphagia, recurrent respiratory tract infections, repeated food bolus impaction, gastroesophageal reflux disease, stricture and poor weight gain. Gap measurement between upper and undivided lower pouch was done by placement of no 8 red rubber catheter in the upper pouch after anterior and lateral mobilization of upper pouch with slight stretching. Minimal mobilization [group A (distal 1 cm of the upper pouch)] was done if the gap was up to 2cm and upper pouch stretching was used to complete primary repair. Extensive mobilization (group B) was done if the gap was more than 2cm for primary repair.
Result- out of 64 cases (38 male, 26 female) operated, 42 (65%) survived. Complete follow-up data of 25 patients (group A-15, group B-10) were available. Group A had mean weight of2.2 Kg (range1.8-2.4kg), operated within 48 hr (range16-72 hrs), a cardiac anomaly in 5(4ASD, 1TOF), mean follow-up 70.53 months (range 48-92 month). 2 pt had frequent URI (mostly within 2 yrs of operation), 2 pts had an episode of food bolus impaction and 1 required dilatation under GA.GER was found in none. In group B mean weight was 2.3 kg (range 1.6-3 kg), operated within 42 hr (range20-72 hrs), no cardiac anomaly, mean follow-up 63.1 months (range 46-87 months). 5 pt had frequent URI (mostly within 2 yr of operation), 5 pt had an episode of food bolus impaction and 3 required dilatation under GA. Poor weight gain was noted in 2, recurrent fistula in 1and GER in 4 pts.
Conclusion- Primary repair of EA-TEF with Minimal mobilization of the upper pouch is a feasible option with better long term outcome as compare to extensive mobilization