[Spontaneous recanalisation of the esophagus].
Main problem in treating newborns with congenital esophageal atresia is a long gap between esophageal segments. There are many publications that describe various techniques of esophageal anastomosis. In our report we observed spontaneous racanalisation of the esophagus. This study reports 3 similar clinical pictures of patients, received and treated in our clinics for III-b type oesophageal atresia (esophageal atresia with distal tracheoesophageal fistula). All newborns were operated, two patients underwent palliative procedures, leaving a diastasis between esophageal pouches, and lining a vicryl string between oesophageal ends; and in one case attempt of primary oesophageal anastomosis turned in to leakage of anastomosis and mediastinitis. All patients were feeded via gastrostomy and in the period of 20-29 th postoperative day revealed regurgitation symptoms. Evaluation of laboratory and instrumental findings lead us to conclusion, that bypass of the oesophagus was reestablished. The thred canal connecting both esophageal pouches was found. Dilatation was introduced to all patients, two of them required subsequent resection of esophageal stricture. CONCLUSIONS. Successful primary esophageal anastomosis - the best choice. Review of the literature allowed authors to detect few criterion that influenced canal formation: open lumen of the esophagus, "vicryl string" and traction. Method of "thred canal formation" is acceptable in cases of inconceivable primary esophageal anastomosis or esophageal anastomosis, complicated with leakage and mediastinitis.
Gurskas
Pranas
P
Clinic of Pediatric Surgery, Vilnius University, Santariskiu 7, 2600 Vilnius, Lithuania.
Ivanauskas
Aidas
A
D000367:Age Factors; D004106:Dilatation; D004933:Esophageal Atresia / Q000000981:diagnostic imaging / Q000601:surgery*; D004940:Esophageal Stenosis / Q000628:therapy; D005500:Follow-Up Studies; D005774:Gastrostomy; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011182:Postoperative Care; D011859:Radiography; D013908:Thoracotomy; D013997:Time Factors; D014138:Tracheoesophageal Fistula / Q000601:surgery*; D016896:Treatment Outcome