선천성 식도 폐쇄증의 예후인자에 대한 임상적 고찰
Prognostic Factor of Congenital Esophageal Atresia
이대성, 김홍용, 김홍주, 배병노, 김기환, 한세환, 김영덕,
소속 상세정보
이대성 ( Lee Dae-Sung )
인제대학교 상계백병원 외과학교실
김홍용 ( Kim Hong-Yong )
인제대학교 의과대학 상계백병원 외과학교실
김홍주 ( Kim Hong-Joo )
인제대학교 의과대학 상계백병원 외과학교실
배병노 ( Bae Byung-Noe )
인제대학교 의과대학 상계백병원 외과학교실
김기환 ( Kim Ki-Whan )
인제대학교 의과대학 상계백병원 외과학교실
한세환 ( Han Se-Hwan )
인제대학교 의과대학 상계백병원 외과학교실
김영덕 ( Kim Young-Duck )
인제대학교 의과대학 상계백병원 외과학교실
KMID : 0371320010610030277
Abstract
Purpose
This study was undertaken in order to analyze clinical data concerning cases of esophageal atresia cases we encountered to elucidate the risk factors that may more accurately predict a prognosis.
Methods
We retrospectively reviewed the medical charts of 19 infants with esophageal atresia diagnosed at Sanggye Paik Hospital from June 1991 to May 2000.
Results
The mean birth weight of the infants was 2.46 kg (0.97∼3.99 kg). Associated anomalies occurred in 12 infants (63.2%), including cardiovascular anomalies in 10 (52.6%), anorectal anomaly in 1 (5.3%), renal anomaly in 1 (5.3%), skeletal anomaly in
1
(5.3%) and chromosomal anomaly in 1 (5.3%). We performed primary end-to-end anastomosis with one layer of interrupted suture in 12 infants. Primary repair was carried out in 7 infants, simultaneously with gastrostomy in 1, and gastrostomy &
delaye
d end-to-end anastomosis was performed in 4. Postoperative complications included pneumonia in 8 (66.7%), leakage in 4 (33.3%), stricture in 4 (33.3%), sepsis in 2 (16.7%), wound infection in 1 (8.3%) and gastroesophageal reflux in 1 (8.3%). The
postoperative mortality rate was 25.0% (3/12). Causes of death included sepsis (n=2) & heart failure (n=1). According to the Waterston criteria, 4 infants (21.1%) were classified as group A, 6 (31.6%) as group B, and 9 (47.3%) as group C. The
postoperative survival rates of group A, B, and C were 100% (3/3), 80% (4/5), and 50% (2/4) respectively. The postoperative survival rates of class I and class II by Montreal classification were 88.9% (8/9) and 33.3% (1/3), respectively.
Conclusion
Our data suggests that associated anomalies and general conditions are more important prognostic factors than birth weights in patients with esophageal atresia.
키워드
식도 폐쇄증; 기관식도루; 예후인자; Esophageal atresia; Tracheoesophageal fistula; Prognostic factor;
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