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Congenital Esophageal Atresia Hiroomi Okuyama 1 1Department of Pediatric Surgery, Osaka University Keyword: congenital esophageal atresia pp.901-906
Published Date 2022/9/20
DOI https://doi.org/10.15106/j_kyobu75_901
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Congenital esophageal atresia, in which the proximal esophagus forms a blind end, results in respiratory failure due to aspiration of saliva. When accompanied by a distal tracheoesophageal fistula, increased intragastric pressure causes gastric juice to reflux into the trachea, resulting in severe pneumonia. Because of the above conditions, surgery should be performed early in life once the diagnosis is made. Conventionally, a two-stage radical operation was performed after gastrostomy. Recently, if the patient is in good general condition, a one-stage radical operation is preferred without gastrostomy.

The patient is positioned in the left lateral recumbent position. The tracheoesophageal fistula is double ligatured near the tracheal junction by extra-pleural approach. After dissection of the upper esophageal blind end, the upper and lower esophagus are anastomosed using a single-layer intermittent suture. In cases of a long gap in which one-stage anastomosis is difficult, two-stage esophageal anastomosis is performed. As the long-term prognosis of esophageal reconstruction using the stomach, small intestine, or large intestine in children is not always good, it is desirable to reconstruct the esophagus using autologous esophagus.

Recently, thoracoscopic repair has been performed for esophageal atresia, and its results have been reported to be comparable to those of open repair.


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電子版ISSN 2432-9436 印刷版ISSN 0021-5252 南江堂

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