Therapeutic outcome of esophago-tracheal fistula treated with endoscopic esophageal clipping
Objective To explore the feasibility and efficacy of esophagotracheal fistula closure in children under gastroscopy.Methods Retrospective analysis was performed for the relevant clinical data of 4 children with esophagotracheal fistula undergoing gastroscopic closure from March 2020 to March 2022.Case 1 was a boy of esophagotracheal fistula due to esophageal foreign body.It was diagnosed definitely by gastroscopy and initially closed at 21 months.The diameter of primary fistula clamp was 10 mm.Cases 2 and 3 developed recurrent esophagotracheal fistula after surgery for congenital esophageal atresia(type Ⅲ).Case 2 was a boy diagnosed by esophagography and gastroscopy and initially closed at 3 months.The diameter of primary fistula clamp was 3 mm.After a confirmation of intraoperative fibrobronchoscopy plus gastroscopy,Case 3 was a girl initially closed at 7 months.Case 4 was a boy of type Ⅱ esophageal atresia misdiagnosed as type Ⅰ esophageal atresia and confirmed by gastroscopy.He had an initial closure at 2 years.The diameter of primary fistula clamp was 1 mm.During regular follow-ups,closure duration,volume of blood loss and total count of clamps at the last follow-up were recorded.Results Esophagotracheal fistula was closed with clamps under gastroscopy.Average closure duration was 18(10-30)min and volume of blood loss＜1 ml.Case 1 underwent closure for a total of 6 times and clinical symptoms disappeared at 4 months.Case 2 was closed thrice and clinical symptoms resolved at 15 months.Case 3 was clamped thrice and intermittent coughing and respiratory infection persisted at 8 months.In Case 4,closure was performed once and clinical symptoms disappeared at 1 month.Conclusions For esophagotracheal fistula in children,gastroscopic closure of esophageal fistula is efficacious with minimal trauma,shorter hospitalization stay and low expense.However,further improvement of instruments and closure modes are required for lowering the recurrent rate.
NETL
NSTL
万方数据
维普
