• Journal of Chest Surgery
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• 제5권2호
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• pp.153-158
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• 1972

The esophageal atresia with tracheoesophageal fistula occurs approximately once in 3, 000 live births. In Korea, about 20 cases were reported with five successful surgical corrections. The atresia characteristically occurs at the level of, or just cephalad to, the carina and is associated with a tracheoesophageal fistula. In about 90% of the cases, the upper esophagus ends in a blind pouch, and the lower esophageal segment communicates with the trachea through the membranous posterior wall just above the carina. Many of the Infants with esophageal atresia have other congenital anomalies. The most common of these are congenital cardiac anomalies, imperforate anus, genitourinary malformations, and intestinal atresia. Recently we experienced four cases of esophageal atresia, of which three were Gross type C and one was type A. Two of them were treated by primary repair, and one [type A] was taken cervical esophagostomy and gastrostomy. The another was refused surgery.

• Advances in pediatric surgery
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• 제17권1호
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• pp.81-87
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• 2011

This study was aimed to evaluate associated congenital anomalies in the patients with esophageal atresia with tracheoesophageal fistula (EA/TEF). Forty-two neonates with the diagnosis of EA/TEF treated over a 10 year period in a single institution were included in this study. The demography of EA/TEF was analyzed. Major associated anomalies including vertebral, anal, cardiac, renal, limb, neurologic and chromosome were reviewed and categorized. Males were slightly more dominant than females (1.47:1) and all patients had Gross type C EA/TEF. Only 19 % of the patients had solitary EA/TEF without associated anomalies. Cardiac anomalies were the most common associated congenital anomaly in patients with EA/TEF (73.8 %). But 47.6 % were cured spontaneously or did not affect patients' life. Atrial septal defect (ASD) was the most common cardiac anomaly followed by patent ductus arterious (PDA) and ventricular septal defect (VSD). Among gastrointestinal anomalies (23.8 %), anorectal malformations were the most frequent, 70 % Vertebral and limb abnormalities accounted for 11.9 % and urogenital malformations 9.5 % of the anomalies in patients with EA/TEF. VACTERL associated anomalies were 23.8 % and 1.8% had full VACTERL. Almost 12 % of EA/TEF had neurologic anomalies. Patients with EA/TEF require preoperative evaluation including neurologic evaluation to detect anomalies not related to VACTERL. Though associated cardiac anomaly occurred in 73.8 % of patients in our study, only 21.42 % needed surgical correction. The authors suggesrs further studies with large numbers of patients with EA/TEF.

• Journal of Chest Surgery
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• 제27권7호
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• pp.603-609
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• 1994

Esophageal atresia is a rare congenital anomaly and it usually associated with tracheo-esophgeal fistula and other congenital anomalies. The first report of esophageal atresia with tracheo-esophageal fistula was done by Thomas Gibson in 1696. In 1941, Haight performed the first successful primary anastomosis for esophageal atresia. These accomplishments opened the gateway for clinical studies that have resulted in reinforcements and improvement in the care of infants born with this anomaly. From January 1986 to April 1994, 14 cases of esophgeal atresia with tracheo-esophgeal fistula were diagnosed in Kyung Hee Uinv. Hospital. There were 9 male and 5 female infants. 12 infants were Gross classification type C and 2 infants were type A. The average body weight was 2.7$\pm$0.4kg and Waterson Category A contained 4 infants, B contained 3 infants and C contained 7 infants. Among these infants, 9 infants were underwent anastomosis procedures. We performed retropleural approach in 6 infants, transpleural approach in 2 infants and 1 infant was performed colon interposition through substernal space.By the method of anastomosis, end-to-side anastomosis was performed in 5 infants, end-to-end anastomosis in 3 infants and esophagocologastrostomy in 1 infant.The former 8 infants were Gross classification type C and the latter was type A. Among the type C infants, 6 infants were anastomosed with one layer interrupted suture and 2 infants with 2 layer interrupted suture. Post- operative death was in 1 infant and 8 infants were discharged with good result and have been in good condition.

• Advances in pediatric surgery
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• 제6권1호
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• pp.40-44
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• 2000

Congenital esophageal stenosis (CES) is a narrowing of the esophageal lumen from birth. Three types of CES have been described; tracheobronchial remnants (TBR), membranous web (MW), and fibromuscular stenosis (FMS). We reviewed the clinical features and the surgical outcome of 14 patients, pathologically confirmed as CES. Nine patients had TBR, 3 FMS, and 2 MVV. The mean age at operation was 3.8 years. Five patients were boys and 9 girls. Four patients had other congenital anomalies. Segmental resection of the lesion and end to end anastomosis was utilized in all cases except one who underwent myotomy. The stenotic segment was located at the distal esophagus in all patients. There were 8 complications in 6 patients, but no mortality. The mean follow-up period was 68 months. There were no feeding problems but 3 patients had minor gastroesophageal reflux. Our result indicates that segmental resection and anastomosis is a satisfactory surgical procedure in the management of CES.

• Journal of Chest Surgery
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• 제48권6호
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• pp.439-442
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• 2015

Tracheal agenesis is an extremely rare and typically lethal congenital disorder. Approximately 150 cases have been described since 1900, and very few cases of survival have been reported. We describe tracheal reconstruction with external esophageal stenting in a patient with Floyd's type II tracheal agenesis. Neither long-term survival nor survival without mechanical ventilation for even a single day has previously been reported in patients with Floyd's type II tracheal agenesis. The infant in the present case survived for almost a year and breathed without a ventilator for approximately 50 days after airway reconstruction using external supportive stents.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권2호
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• pp.79-86
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• 2017

Purpose: Congenital esophageal atresia (CES) is a rare congenital disease. The severity of symptoms is variable; thus, diagnosis is difficult and tends to be delayed. CES is frequently accompanied by esophageal atresia (EA) with/without tracheoesophageal fistula (TEF). We investigated the characteristics of CES by reviewing our experience with CES patients and researched the differences between CES with EA-TEF and isolated CES. Methods: A total of 31 patients underwent operations for CES were reviewed retrospectively. The patients were divided into two groups according to the association with EA-TEF, and compared the differences. Results: Sixteen boys and 15 girls were included. The mean age at symptom onset was 8 months old, and the mean age at diagnosis was 21 months old. Nine patients with EA-TEF were included group A, whereas the other 22 patients were assigned to group B. There were no differences in sex, gestational age, associated anomalies and pathologic results between the groups. In group A, the age at diagnosis and age at surgery were younger than in group B despite the age at symptom occurrence being similar. Postoperative complications occurred only in group A. Conclusion: In this study, symptoms occurred during the weaning period, and vomiting was the most frequent symptom. CES patients with EA-TEF tended to be diagnosed and treated earlier despite the age at symptom occurrence being similar. CES patients with EA-TEF had more postoperative complications; therefore, greater attention should be paid during the postoperative period.

• Journal of Chest Surgery
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• 제28권9호
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• pp.869-871
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• 1995

Esophageal duplication cysts are uncommon, benign lesions of the esophagus. They are rare congenital foregut anomalies. To be considered an esophageal duplication cyst, a lesion must meet the following criteria:1 the cyst in the esophageal wall 2 the cyst is covered with a muscularis propria,generally of two layers and 3 the cyst has an epithelial lining consistent with that of the 4 week embryo, which may be columnar or pseudostratified columnar, and may be ciliated. Herein we report a case of an esophageal cyst located within the thoracic cavity, which is, to the best of our knowledge, the first case reported in Korea. Surgery is generally the treatment of choice for esophageal cyst, and was indicated in this case for the diagnosis and management of symptoms attributable to the cyst.

• 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.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제8권2호
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• pp.137-142
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• 2005

목 적: 소아의 선천성 및 후천성 식도 질환의 치료에 있어 내시경적 풍선 확장술의 안전성, 효과 그리고 기술적인 문제들을 평가하였다. 방 법: 1993년부터 10년 동안 선천성 및 후천성 식도 질환의 치료로 부산대학교병원 소아과에서 내시경적 풍선 확장술을 시행한 8명을 대상으로 이들의 의무 기록을 후향적으로 분석하였다. 시술은 풍선 카테터를 내시경 겸자구를 통해 삽입하여 내시경 직시 하에서 시행되었으며 최초로 사용되는 풍선의 크기는 식도의 내경과 협착 부위의 직경에 기초하여 결정하였다. 협착이 아주 심한 경우에는 먼저 유도 철선을 통과시킨 후, 유도 철선을 따라 풍선 카테터를 삽입시켰다. 풍선을 협착 부위에 위치시키고 서서히 확장하면서 목표하는 크기로 풍선이 팽창되면 1분 동안 확장된 상태를 유지하였다가 감압하여 1분 이상의 휴식을 가졌다. 확장 후 합병증이 없으면 풍선의 직경을 1 mm 간격으로 늘리면서 추가 확장하였다. 결 과: 남아가 3명, 여아가 5명이었고, 평균 연령은 4.2세였다. 8명의 환자에서 27회(환자 당 평균 3.2회)의 확장이 시행되었다. 기저 질환의 종류는 선천 성 식도 폐쇄에 대한 수술 후 발생한 식도 협착이 3예, 식도윤이 2예, 그 외 식도 무이완증, 빙초산에의한 부식성 식도염 그리고 고압성 식도 하부 괄약근이 각각 1예였다. 6~15 mm 직경의 풍선을 사용하였고, 최초 풍선의 크기는 협착의 형태와 정도에 따라 결정되었다. 합병증으로는 식도 천공과 심한 호흡 곤란이 각각 1예 있었다. 6예(75%)에서 시술 후 정상적인 음식 섭취를 보였다. 결 론: 내시경적 풍선 확장술은 소아의 선천성 및 후천성 식도 질환을 치료하는데 있어 안전하고 효과적인 방법이다.

• Advances in pediatric surgery
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• 제3권1호
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• pp.15-23
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• 1997

During a 6-year period, from January 1990 to December 1995, 101 neonates with congenital anomalies were admitted to the division of Pediatric Surgery of Youngdong Severance Hospital. All of them had prenatal screening more than once with ultrasound. Fifty eight of them had prenatally detectable anomalies by ultrasonography. However abnormalities were prenatally detected in 24 neonates(41%). The detection rate was 70% in patientws who had the prenatal screening at our hospital, whereas, the rate was 24% when it was performed at other medical facilities. Duodenal and jejuno-ileal atresia showed the highest detection rate(86%) followed by abdominal mass. Esophageal atresia was suggested by maternal polyhydramnios in 3 patients (25%). Only one patient with diaphragmatic hernia(1.75%) was prenatally detected and none with gastroschisis. The mean interval from birth to operation was 32 hours in the prenatally detected patients and 50 hours in the non detected. The complication rate and the mortality after emergency operation were 20% and 7% in the detected group, and 58% and 23% in the nondetected, respectively. The average period of the hospitalization was 20 days in the detected group and 39 days in the nondetected. We conclude that the prenatal detection of anomalies is necessary to ensure adequate care for the mothers and the babies with congenital anomalies. This includes early transfer, timing of optimal delivery and operation.