• Title/Summary/Keyword: tracheoesophageal

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Esophageal Atresia and Tracheoesophageal Fistula in Korea - A National Survey of Its Members by the Korean Association of Pediatric Surgeons - (선천성 식도 무공증 및 기관식도 누공 - 대한 소아외과학회 회원을 대상으로 한 전국 조사 -)

  • Park, W.H.;Kwon, S.I.;Kim, S.C.;Kim, S.K.;Kim, W.K.;Kim, I.K.;Kim, J.E.;Kim, H.H.;Park, K.W.;Park, Y.S.;Song, Y.T.;Yang, J.W.;Oh, S.M.;Yoo, S.Y.;Lee, D.S.;Lee, M.D.;Lee, S.C.;Lee, S.K.;Lee, T.S.;Chang, S.I.
    • Advances in pediatric surgery
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    • v.1 no.2
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    • pp.149-161
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    • 1995
  • The first national survey on esophageal atresia and tracheoesophageal fistula was conducted to access the current status of its incidence, clinical manifestation, preoperative diagnosis and management, type of its anomaly, associated anomalies, and surgical results and course. The 43 members of the Korea Association of Pediatric Surgeons received questionnaires and registration forms to be filled out on each patient who were born during the three years from January 1, 1992 through December 31, 1994. Questionnaires composed of six broad areas which include 1) preoperative diagnosis and management, 2) surgical technic, 3) long gap, 4) postoperative management, and 5) complications and courses. A total of 148 cases was returned by 28 members working at 23 institutions and 27 members returned questionnaires. We obtained the following results by analysis of the 148 cases of tracheoesophageal anomalies. The incidence of tracheoesophageal anomaly was about 1/10,000-11,000 in 1994, which is one third of that of anorectal malformations in Korea and the distribution of the patients was almost proportionate to the size of each province. Both sexes are about equally affected. Majority of the members make diagnosis of tracheoesophageal anomaly by taking a simple infantogram with a radiopaque tube in upper pouch and a little under half(46%) prefers to perform echocardiography as a part of preoperative management to identify congenital heart disease and lateralize the aorta. Esophageal atresia with distal TEF(87.5%) was by far the most common and there were pure esophageal atresia(5.6%), H-type TEF(2.1%), and so on. About half(49%) of the patients had one or more associated anomalies in addition to tracheoesophageal anomalies. Congenital heart disease was associated in 46 cases(31%), anorectral malfomations in 19 cases(13%), musculoskeletal anomalies in 15 cases(10%), genitourinary anomalies in 10 cases(7%) and gastrointestinal anomalies in 7 cases(5%). Postoperatively, parenteral nutrition and assisted ventilation were given in 66% and 52% of patients respectively. Ninety three(74%) of 126 cases who underwent sugical procedure, experienced one or more complications such as respiratory complication(65%), leak(22%), stricture(21%) and so on. The survival rates related to the Waterston risk categories were 90.2% in group A, 71.4-75% in $B_1$, $B_2$, and $C_1$, groups, and 28% in group $C_2$, and the overall survival rate was 71.4%. Thirty six(28.6%) of 126 cases died of pneumonia/sepsis(12 cases), respiratory failure(12 cases), and congenital heart disease(4 cases). With short term follow-up, 69% of patients have been excellent whereas remainders of the cases have suffered from some sort of morbidity related to gastroesophageal reflux, recurrent respiratory infection, and esophageal stricture.

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Esophageal Atresia with Distal Tracheoesophageal Fistula in Both Members of Monozygotic Twins (일란성 쌍둥이 모두에서 발생한 식도무공증)

  • Kim, Seong-Chul;Nam, So-Hyun;Kim, Dae-Yeon;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.15 no.2
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    • pp.157-160
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    • 2009
  • Although the incidence of esophageal atresia (EA) is higher in twins than in singletons by two to three times, EA usually affects only one member of twins. We report one pair of twins concordant for EA. A 31-year-old healthy woman bore monozygotic female twins at 36 weeks of gestation. They weighed 2,216 and 2,480 g, respectively. They had EA with distal tracheoesophageal fistula and underwent primary esophageal anastomosis on the birth day and the $2^{nd}$ day of life, respectively. Twin A also had suspicious antral obstruction and pyloroplasty was done simultaneously with esophageal repair. She needed antral web excision for continued gastric stasis one month after $1^{st}$ operation and three balloon dilatations of the esophagus. Twin B recovered uneventfully.

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Voice Rehabilitation after Total Laryngectomy (후두전절제술 후 음성재활)

  • Jang, Jeon Yeob
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.1
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    • pp.18-20
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    • 2016
  • Total laryngectomy remains as an important treatment option in selected patients with laryngopharyngeal cancers, which inevitably sacrifices naturally produced voice. Much effort has been devoted to voice restoration for these laryngectomized patients. Several ways of voice rehabilitation after total laryngectomy have been developed and utilized thus far, including tracheoesophageal shunt speech, esophageal speech, pneumatic speech aid, and electrolarynx. Of these, tracheoesophageal shunt speech appears to be the most effective voice restoration method, while other trials might also be useful in special situations. Nevertheless, each method has its own unique mechanisms of voice production, thus has its advantages and drawbacks in clinical setting. In this review, we discuss the currently available management options for the rehabilitation of laryngectomized voice.

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Surgical Experience of Esophageal Atresia Associated with Tracheoesophageal Fistula (기관식도루를 동반한 선천성 식도 폐쇄증 : 치험 5례)

  • Song, Jin-Cheon;An, Byeong-Hui;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.396-401
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    • 1990
  • This report is an review of 5 cases of congenital esophageal atresia associated with tracheoesophageal fistula which were treated in the Department of Thoracic and Cardiovascular Surgery, Chonnam University Hospital from January, 1987 to February, 1989. First patient that was associated with VATER’s syndrome and moderate pneumonia, i.e., Waterston Category C was treated by gastrostomy, colostomy and primary anastomosis, but expired. Second patient that was weighed 2.2 Kg, suffered from moderate pneumonia was treated by gastrostomy, but died from asphyxia. The other patients were treated by primary repair. Any anastomotic leakage or gastroesophageal reflux was not found in these cases, but mild anastomotic strictures were found in these patients by postoperative esophagography. However, esophageal dilatation of anastomotic strictures was successful using the Griintzig balloon catheter.

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Congenital Esophageal Atresia with Tracheoesophageal Fistula - A Case Report - (선천성 식도폐쇄 및 간식도루 1례 보)

  • 손동섭
    • Journal of Chest Surgery
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    • v.20 no.3
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    • pp.565-569
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    • 1987
  • The first description of the pathologic anatomy of esophageal atresia was presented by Duration in 1670, it was not successfully treated until 1939 when the first two survivors of staged correction were described by Ladd and Levin. In 1941 Haight and Towsley performed the first successful primary repair. Recently we were experienced a case of esophageal atresia with tracheoesophageal fistula an infant patient who presented the symptoms of vomiting and dyspnea. The diagnosis was made by the esophagography with Diagnosis. The operation was performed extrapleurally through 4th intercostal space after gastrostomy. The fistula was closed by triple ligation and the upper pouch was then brought into apposition with the presenting surface of the lower esophageal segment and an end to side anastomosis was fashioned with a single layer of sutures. Operative patient tolerated all the operative procedure well in spite of postoperative respiratory complication and recovered uneventfully, permitted feeding on 9th postoperative day after esophagography.

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