食管闭锁术后食管气管瘘复发的治疗进展

Treatment advances for recurrent tracheoesophageal fistula after esophageal atresia operations

食管闭锁是一种常见的先天性消化系统畸形，手术治疗是唯一有效的治疗方式。但术后常发生一系列并发症，其中以食管气管瘘复发最为棘手。目前食管气管瘘复发的治疗以外科手术为主，然后围手术期的管理及二次手术的困难一直是小儿外科医师所面临的一项挑战。基于近年来国内外对于食管闭锁术后食管气管瘘复发的研究，本文介绍了食管气管瘘复发的围手术期管理技巧，简述了在外科手术方面提高食管气管瘘复发治愈率的要点及进展。同时也回顾了近年来内镜下治疗食管气管瘘复发的各种方法，分析了其优缺点及适应证。指出目前外科治疗治愈率已明显提高，内镜治疗也日益完善，并对将来的治疗研究方向进行展望。

Esophageal atresia, a common congemtat mallormatlons oI algesnve system, mway~ requires surgical resection. However there are a variety of postoperative complications, including recurrent tracheoesophageal fistula （rTEF）. This review has described the perioperative skills, latest advances and optimal techniques of managing rTEF. Also the advantages, disadvantages and indications of various endoscopic therapies for rTEF were summarized. Future trends are predicated.