• 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 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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• 제12권2호
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• pp.175-182
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• 2006

VATER association is defined as a combination of 3 or more anomalies- vertebra (V), imperforate anus (A), esophageal atresia with or without tracheoesophageal fistula (TE), renal and radial anomaly(R). We reviewed our experiences in one center to determine etiology, prevalence, clinical manifestation, other associated anomaly and prognosis. Two hundred and twenty-three cases that underwent operations for imperforate anus or esophageal atresia were analyzed retrospectively through medical records at Department of Pediatric Surgery, Asan Medical Center from June, 1989 to July, 2005. The total number of neonates who had been admitted during period of study were 46,773 and VATER association was 9 (0.019 %, 1.92 persons per 10,000 neonates). Median gestational age and birth weight were $37^{+4}wk$ ($35^{+1}$ - $41^{+4}$) and 2,594 g (1,671-3,660), respectively and median age of mother was 32 years (23-38). There was no family history. Three patients were twins but their counterparts had no anomalies. Patients who have 3 anomalies were 6, 4 anomalies in two and 5 anomalies in one patient. Vertebra anomalies were detected in 7(77.7 %), imperforate anus in 8(88.9 %), esophageal atresia in 5 patients (55.6 %), renal anomaly in 6(66.7 %), and radial anomaly in 5(55.6 %), respectively. Four patients are alive, 2 patients were lost during follow up period. Three patients died due to neonatal sepsis, respiratory dysfunction and cardiac failure. VATER association did not appear to be a definite risk factor, but merely a randomized combination of 5 anomalies. The prognosis was dependent on the other associated anomalies, appropriateness of management and operation. Careful follow-up and aggressive treatmentare required for improving survival and quality of life.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권1호
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• pp.28-33
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• 2013

Purpose: Anorectal malformations are often associated with other anomalies, reporting frequency with 40-70%. Gastrointestinal anomalies have been known to be relatively less common than associated anomalies of other organ system. This study was performed to assess a distinctive feature of cases associated with esophageal atresia. Methods: Clinical data (from January 2000 through December 2011) on the 196 subjects with anorectal malformations, managed in our Hospital, were reviewed. Total 14 neonates were identified with accompanying esophageal atresia and retrospective analysis was conducted. Results: The incidence was 7.1% and there were 8 male and 6 female subjects. Only 2 cases were associated with esophageal atresia without tracheoesophageal fistula. Although variable cases of anorectal malformation in female subjects, almost cases were anorectal malformations with rectourethral fistula in male. Other associated anomalies were identified in all cases, with more than 3 anomalies in 10 cases. There were 4 VACTERL (Vertebral abnormalities, Anal atresia, Cardiac anomalies, Tracheoesophageal fistula, Esophageal atresia, Renal and Limb anomalies) associations accounting for 28.6%, but could not identify chromosomal anomaly. Most cases were managed with staged procedure, usually primary repair of esophageal atresia and diverting colostomy. Overall mortality rate was 21.4%, mainly caused by heart problems. Conclusion: This study shows that early diagnosis and rational surgical approach with multidisciplinary plan are mandatory in managing anorectal malformations with esophageal atresia, when considering a high frequency of associated anomaly and a relative high mortality.

• Advances in pediatric surgery
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• 제9권2호
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• pp.131-133
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• 2003

• 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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• 제28권10호
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• pp.932-934
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• 1995

Esophageal stenosis due to ectopic tracheobronchial remnants is an uncommon anomaly and only few cases were reported in the literature. We have experienced two case of esophageal stenosis due to ectopic tracheobronchial remnants and performed operative correction. The one patient was a five year old male with a chief complaint of swallowing difficulty from birth and the other was a twenty-three year old female with a slowly incresing symptom of dysphagia for twenty years. both of them were performed surgical correction by esophagectomy of the stenotic portion and esophago-gastrostomy with anti-reflux procedures. The resected specimens of the these two patients showed ectopic tracheobronchial chondroepithelial tissue withinthe esophageal wall histipathologically. Postoperative course was uneventful and have been in good condition without any problems.

• Journal of Chest Surgery
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• 제39권8호
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• pp.643-647
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• 2006

선천적으로 발생한 식도 폐쇄증과 연관된 기관연화증은 매우 드문 기형이다. 본 증례는 생후 1일째 식도 폐쇄증 수술을 받은 환아가 기관연화증으로 진단되어 생후 40일에 교정수술을 하였다. 식도수술 후에 진행하는 호흡곤란과 천명음을 보였으며, 삼차원 컴퓨터촬영상 기관 중부에 심한 협착소견을 보였다. 심폐바이패스 하에서 협착부를 절제하고 단단 문합하였다. 조직학적 검사상 연골이 없을 뿐 아니라 식도조직을 보여 선천성 기관연화증으로 진단할 수 있었다.

• Advances in pediatric surgery
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• 제14권1호
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• pp.88-93
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• 2008

Esophageal atresia with double tracheoesophageal fistula is a very rare anomaly and is difficulty to diagnose preoperatively. We treated a full term baby with esophageal atresia with double tracheoesophageal fistula. At the first operation, only the distal tracheoesophageal fistula was identified and ligated. When the upper esophageal pouch was opened, intermittent air leakages in sequence with positive bagging were noticed. However, intraoperative bronchoscopy did not identify a fistula in the proximal pouch, and the operation was completed with end to end anastomosis of the esophagus. On the $7^{th}$ postoperative day, esophagography showed another tracheoesophageal fistula proximal to the esophageal anastomosis. A wire was placed in the fistula preoperatively under bronchoscopy. At the 2nd operation through the same thoracotomy incision the proximal fistula was identified and ligated. On the $12^{th}$ postoperative day, esophagography showed neither stricture nor leakage.

• Journal of Chest Surgery
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• 제43권6호
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• pp.820-823
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• 2010

최근 저체중출생아의 식도 폐쇄에 대한 일차완전교정술이 양호한 성적으로 이루어지고 있으나 극소저체중출생아에 대한 치료법에 대해서는 논란이 있다. 저자들은 쌍생아 중 한 명으로 체중 1,270 g으로 태어난 미숙아에서 기관식도루를 동반한 식도폐쇄를 단계적 수술로 식도단단문합을 성공적으로 시행하였기에 보고한다.