长段缺失型食管闭锁手术方式的应用现状与研究进展

Current status and research advances of surgical approaches for long-gap esophageal atresia

先天性食管闭锁(esophageal atresia,EA)是新生儿期严重的消化道疾病。随着新生儿外科手术、麻醉、监护技术的提高以及静脉高营养的应用,EA的治愈率不断增高,但手术后并发症仍然是影响患者远期预后与生存质量的重要因素。如何降低手术后并发症的发生率是临床研究的重点。食管缺失长度是长段缺失(long-gap esophageal atresia,LGEA)型食管闭锁手术后吻合口瘘、食管狭窄、胃食管反流等并发症的独立影响因素。目前LGEA在定义、评估以及手术方法的选择上尚未达成共识,治疗上仍然具有一定的挑战性。本文阐述LGEA手术方式的应用现状与研究进展,旨在为临床医生治疗决策提供参考。

Congenital esophageal atresia(EA)is one of critical diseases of digestive tract during neonatal period.With wider applications of neonatal surgery,pediatric anesthesia,neonatal monitoring and total parenteral nutrition(TPN),its curative rate is rising yearly.Currently reducing its postoperative complications has become a new research focus.Long-gap esophageal atresia(LGEA)an independent risk factor of anastomotic fistula,esophageal stricture and gastroesophageal reflux.Consensus is lacking on its definition,evaluations and surgical approaches.And its treatment remains challenging.Summarizing the latest status and recent research advances of surgical approaches for LGEA,this review aimed to provide practical references for surgeons to select appropriate surgical approaches to reduce postoperative complications.