C型食道閉鎖症の気管食道瘻の根治術後再開通と根治術待期中の再発について

概要

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According to the literature, the term of "recurrence of T. E. F." is limitted to postoperative complication of esophageal repair in C-type esophageal atresia, but "recommunication of T. E. F." is also found during waiting for radical repair of esophagus after separating T. E. F. by primary operation. Of our 18 cases of esophageal atresia with TEF, we have reported 2 cases of the former type and 3 cases of the latter type, of which 2 cases died of pneumonia and were found recummunicating TEF at autopsy. From our experience, it was concluded as follows: 1) Two types of recurrent TEF exsist after and before radical repair of congenital esophageal atresia with TEF, and many cases of recommunication before esophageal repair are suspected to be dead without difinitive diagnosis. 2) Prejudice of "previous separation of TEF" inhibits to establish the diagnosis. Reseparation must be tried soon after improvement of lung findings as the mortality is high with conservative therapy. 3) Findings at autopsy and reoperation in the latter type suggest that minor leakage and abscess may penetrate the blind end of the lower esophagus and the trachea and the loosened ligature materials are expelled. Then abscess wall is firmly built and forms "recommunication of TEF" as if it had not been separated.
1982-12-20