治疗长间隔食道缩症的方法
Annalise B Penikis1, Anne M Sescleifer1, Shaun M Kunisaki1
1Division of General Pediatric Surgery, Johns Hopkins Children's Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Translational pediatrics
|March 8, 2024
概括
患有长间隔食道缩症 (LGEA) 的婴儿需要专门的手术修复. 推迟的初级修复是首选的,在必要时使用胃管用于食道替换.
科学领域:
- 儿科手术 儿科手术
- 胃肠病学 胃肠病学
- 新生儿科学 新生儿科学
背景情况:
- 长间隔食道缩 (LGEA) 在新生儿中构成重大手术挑战,因为食道段太远,无法立即连接.
- 消化道缩症的A型变体经常与LGEA有关.
研究的目的:
- 为LGEA提供基于证据的当前挑战和管理策略的综述.
- 突出外科手术技术的进步和对LGEA治疗的合作研究.
主要方法:
- 对LGEA管理现有文献的审查,包括单中心回顾性研究和最近的多中心合作.
- 对各种手术修复技术的分析:延迟的初级修复,带着引的分阶段修复和食道置换.
主要成果:
- 延迟初级修复是美国和欧洲推的初始方法,符合美国儿科外科协会的指导方针.
- 胃管是食道置换的首选,因为操作简单,患病率低,耐用性强.
- 多中心合作正在提高对LGEA的理解和管理.
结论:
- 综合的长期随访对于监测LGEA患者的吞,营养,呼吸系统健康和逆流等结果至关重要.
- 优化手术策略和合作研究是改善LGEA婴儿护理的关键.
相关概念视频
Esophageal Perforation-II: Clinical Manifestations and Management
63
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
63
Esophageal Strictures-II: Clinical Features and Management
70
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
70
Barrett Esophagus-II: Clinical Manifestations and Management
150
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
150
Gastroesophageal Reflux Disease II: Clinical Features and Management
80
Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
80
Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
132
Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
132
Esophageal Strictures-I: Introduction
99
Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
99


