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目的:探讨Ⅰ期胃代食管术治疗Ⅲa型食管闭锁的疗效。方法:对2008年3月至2013年6月我院采用Ⅰ期胃代食管术治疗的8例Ⅲa型食管闭锁进行回顾性分析。其中男6例,女2例,食管两盲端距离均大于3 cm。结果:所有患儿均顺利完成手术。6例治愈出院,1例死亡,1例家长放弃治疗。术后5例有严重肺炎,近期吻合口瘘2例。随访6个月至5年,吻合口狭窄2例,均行食管扩张术治愈,轻度胃食管反流4例,均未行抗反流手术,采用少量多餐及体味喂养治疗后症状缓解。结论:新生儿期采用Ⅰ期胃代食管术治疗Ⅲa型食管闭锁临床可行,避免了分期手术,缩短了治疗周期,有助于提高治愈率。
Objective: To investigate the efficacy of stage Ⅰ gastroesophageal esophagectomy in the treatment of type Ⅲ a esophageal atresia. Methods: From March 2008 to June 2013, 8 cases of type Ⅲ a esophageal atresia treated with stage Ⅰ gastric esophageal esophagectomy in our hospital were retrospectively analyzed. There were 6 males and 2 females, and the distance between the two ends of esophagus was more than 3 cm. Results: All children completed the operation smoothly. Six patients were cured, one died, and one patient gave up treatment. 5 cases had severe pneumonia after operation, and 2 cases had anastomotic fistula recently. All patients were followed up for 6 months to 5 years. Two patients had anastomotic stenosis. All patients underwent esophageal dilation and 4 patients with mild gastroesophageal reflux had no anti-reflux surgery. The symptoms were relieved with a few meals and body odor. Conclusion: Stage Ⅰ gastric esophageal esophagectomy for type Ⅲa esophageal atresia is feasible in neonatal period, avoiding staging surgery, shortening the treatment cycle and improving the cure rate.