Preoperative tracheobronchoscopy(TBS) in the diag-nostic assessment of newborns affected by esophageal atresia(EA) was described in 1981. Nevertheless, the value of the procedure is actually much debated; only a few s...Preoperative tracheobronchoscopy(TBS) in the diag-nostic assessment of newborns affected by esophageal atresia(EA) was described in 1981. Nevertheless, the value of the procedure is actually much debated; only a few studies have clearly explored the advantages of TBS and this procedure is not yet routinely included inthe diagnostic and therapeutic assessment in many in-ternational pediatric surgery settings. Routine preoper-ative TBS is a safe procedure that enables the accurate examination of the tracheobronchial tree, the visualiza-tion of tracheoesophageal fistula and the diagnosis of tracheomalacia or associated respiratory anomalies. When a distal fistula is found, its occlusion with a Fog-arty balloon catheter improves mechanical ventilation and facilitates surgical repair. This review provides a detailed overview on the use of TBS in newborns with EA, focusing on technical aspects, anesthesiological management, indications and limits. The benefits and risks of the procedure are also compared with alterna-tive diagnostic tools, such as an esophageal contrast study, computed tomography scan and ultrasound.展开更多
Jejuno-jejunal intussusception is a rare complication of feeding jejunostomy tube placement. A case of one year old child who underwent gastric pull-up for complicated tracheo-esophageal fistula had jejuno-jejunal int...Jejuno-jejunal intussusception is a rare complication of feeding jejunostomy tube placement. A case of one year old child who underwent gastric pull-up for complicated tracheo-esophageal fistula had jejuno-jejunal intussusception induced by Witzel's feeding jejunostomy tube;is discussed with review of literature.展开更多
Background: Esophageal Atresia and Tracheo-Esophageal Fistula (EA/TEF) occurs sporadically and its eti-ology is poorly understood. We observed six cases of EA/TEF within three weeks of October 2007 at the Lagos Univer...Background: Esophageal Atresia and Tracheo-Esophageal Fistula (EA/TEF) occurs sporadically and its eti-ology is poorly understood. We observed six cases of EA/TEF within three weeks of October 2007 at the Lagos University Teaching Hospital (LUTH), Nigeria. Aims: To analyze the monthly trends of presentation of EA/TEF at the LUTH from 2002-7, test the hypothesis that the October figures were not due to chance and correlate data with known local disease patterns. Setting: Lagos University Teaching Hospital, Nigeria. Patients, Materials, Method: A retrospective analysis of all EA/TEFs managed at the LUTH within stated period. Results: 25 babies with EA/TEF presented over the period. 10 (40%) were seen in the month of Oc-tober, 5 (20%) occurred in May while the rest were spread over the rest of the months. Chi-square analysis confirmed that the EA/TEF cases occurred significantly more frequently in October (P < 0.001) and this ob-servation was unlikely due to chance. Conclusions: There seems to be a seasonal variation in the occurrence of EA/TEF in Lagos, with a significantly higher frequency in the month of October. 96% of mothers of ba-bies with EA/TEF lived in low socioeconomic parts of Lagos. This study highlights the possibility of local viral etiology of EA/TEF.展开更多
Background:Transanastomotic feeding tube (TAFT) is commonly used for post-operative enteral nutrition after esophageal atresia (EA)/tracheoesophageal fistula (TEF) repairs.The purpose of this study is to analyze the t...Background:Transanastomotic feeding tube (TAFT) is commonly used for post-operative enteral nutrition after esophageal atresia (EA)/tracheoesophageal fistula (TEF) repairs.The purpose of this study is to analyze the therapeutic implications of avoiding a TAFT and its impact on the outcomes post-operatively.Methods:The medical data of 33 inpatients with EA/TEF type C repair from 2009 to 2014 were retrospectively reviewed.Patients were divided into two groups for comparison based on the usage of TAFT during the repair:TAFT-(without) and TAFT+ (with) groups,without randomization.Both groups were compared statistically for post-operative complications and outcomes.Results:Eighteen neonates were males and 15 females,with an average birth weight of 2.43±0.43 kg and a mean gestational age of 36.15 weeks.Nineteen (57.5%) in the TAFT-group and 14 (42A%) were in the TAFF+ group.The post-operative complications,need for dilatations,duration of total parenteral nutrition (TPN) and length of hospital stay were similar in both groups.The incidence of pneumonitis was significantly higher in the TAFT+ group.Conclusions:By avoiding a TAFT,there is no increase in complication rates nor does it entail a prolonged period of TPN.Besides,not using a TAFT may have the advantage of reducing incidence of aspiration and consequent pneumonifis.展开更多
目的 比较无喉者发不同元音时的声学参数及气管内压的异同。方法 检测了 2 4例喉全切除气管断端膜样部食管吻合分流发声重建术后患者和 16例喉全切除术后食管音患者分别发元音 a 和 i 时的声学参数 ,测定了 2 0例发声重建术后患者分别...目的 比较无喉者发不同元音时的声学参数及气管内压的异同。方法 检测了 2 4例喉全切除气管断端膜样部食管吻合分流发声重建术后患者和 16例喉全切除术后食管音患者分别发元音 a 和 i 时的声学参数 ,测定了 2 0例发声重建术后患者分别发 a 和 i 时的气管内压 ,并进行统计学分析。结果 两组无喉患者发不同元音 a 和 i 时 ,其声学参数无显著性差异 (P >0 .0 5 ) ,发声重建术后患者的气管内压发 i 音时较发 a 音时高 ,有显著性差异 (P <0 .0 5 )。结论 应用元音 a 和 i 在评价无喉者发声的声学参数有一致的临床意义 ;而发声重建术后患者在发不同元音时 。展开更多
文摘Preoperative tracheobronchoscopy(TBS) in the diag-nostic assessment of newborns affected by esophageal atresia(EA) was described in 1981. Nevertheless, the value of the procedure is actually much debated; only a few studies have clearly explored the advantages of TBS and this procedure is not yet routinely included inthe diagnostic and therapeutic assessment in many in-ternational pediatric surgery settings. Routine preoper-ative TBS is a safe procedure that enables the accurate examination of the tracheobronchial tree, the visualiza-tion of tracheoesophageal fistula and the diagnosis of tracheomalacia or associated respiratory anomalies. When a distal fistula is found, its occlusion with a Fog-arty balloon catheter improves mechanical ventilation and facilitates surgical repair. This review provides a detailed overview on the use of TBS in newborns with EA, focusing on technical aspects, anesthesiological management, indications and limits. The benefits and risks of the procedure are also compared with alterna-tive diagnostic tools, such as an esophageal contrast study, computed tomography scan and ultrasound.
文摘Jejuno-jejunal intussusception is a rare complication of feeding jejunostomy tube placement. A case of one year old child who underwent gastric pull-up for complicated tracheo-esophageal fistula had jejuno-jejunal intussusception induced by Witzel's feeding jejunostomy tube;is discussed with review of literature.
文摘Background: Esophageal Atresia and Tracheo-Esophageal Fistula (EA/TEF) occurs sporadically and its eti-ology is poorly understood. We observed six cases of EA/TEF within three weeks of October 2007 at the Lagos University Teaching Hospital (LUTH), Nigeria. Aims: To analyze the monthly trends of presentation of EA/TEF at the LUTH from 2002-7, test the hypothesis that the October figures were not due to chance and correlate data with known local disease patterns. Setting: Lagos University Teaching Hospital, Nigeria. Patients, Materials, Method: A retrospective analysis of all EA/TEFs managed at the LUTH within stated period. Results: 25 babies with EA/TEF presented over the period. 10 (40%) were seen in the month of Oc-tober, 5 (20%) occurred in May while the rest were spread over the rest of the months. Chi-square analysis confirmed that the EA/TEF cases occurred significantly more frequently in October (P < 0.001) and this ob-servation was unlikely due to chance. Conclusions: There seems to be a seasonal variation in the occurrence of EA/TEF in Lagos, with a significantly higher frequency in the month of October. 96% of mothers of ba-bies with EA/TEF lived in low socioeconomic parts of Lagos. This study highlights the possibility of local viral etiology of EA/TEF.
文摘Background:Transanastomotic feeding tube (TAFT) is commonly used for post-operative enteral nutrition after esophageal atresia (EA)/tracheoesophageal fistula (TEF) repairs.The purpose of this study is to analyze the therapeutic implications of avoiding a TAFT and its impact on the outcomes post-operatively.Methods:The medical data of 33 inpatients with EA/TEF type C repair from 2009 to 2014 were retrospectively reviewed.Patients were divided into two groups for comparison based on the usage of TAFT during the repair:TAFT-(without) and TAFT+ (with) groups,without randomization.Both groups were compared statistically for post-operative complications and outcomes.Results:Eighteen neonates were males and 15 females,with an average birth weight of 2.43±0.43 kg and a mean gestational age of 36.15 weeks.Nineteen (57.5%) in the TAFT-group and 14 (42A%) were in the TAFF+ group.The post-operative complications,need for dilatations,duration of total parenteral nutrition (TPN) and length of hospital stay were similar in both groups.The incidence of pneumonitis was significantly higher in the TAFT+ group.Conclusions:By avoiding a TAFT,there is no increase in complication rates nor does it entail a prolonged period of TPN.Besides,not using a TAFT may have the advantage of reducing incidence of aspiration and consequent pneumonifis.
文摘目的 比较无喉者发不同元音时的声学参数及气管内压的异同。方法 检测了 2 4例喉全切除气管断端膜样部食管吻合分流发声重建术后患者和 16例喉全切除术后食管音患者分别发元音 a 和 i 时的声学参数 ,测定了 2 0例发声重建术后患者分别发 a 和 i 时的气管内压 ,并进行统计学分析。结果 两组无喉患者发不同元音 a 和 i 时 ,其声学参数无显著性差异 (P >0 .0 5 ) ,发声重建术后患者的气管内压发 i 音时较发 a 音时高 ,有显著性差异 (P <0 .0 5 )。结论 应用元音 a 和 i 在评价无喉者发声的声学参数有一致的临床意义 ;而发声重建术后患者在发不同元音时 。
