C 型食道閉鎖症における腹部食道 Banding 法の合併症と問題点について

概要

論文の詳細を見る
Eight high risk cases of esophageal atresia (Gross C type) were managed by esophageal banding using a silastic sheet. Four of the patients died because of the associated major cardiac anomalies. Other patients were alive and underwent anastomosis of esophagus satisfac-torily. In all cases, there was no sign of reflux of gastric contents to the trachea after the banding. It was considered that this procedure was safe and useful in the management of extremely premature or critically ill babies with esophageal atresia and tracheoesophageal fistula. On the other hand, unfavorable complications were encountered in some of our cases. They included disruption, stricture and weakness of the banding site, histological dissection of the muscle layer and reduced peristalsis demonstrated by the esophagogram with contrast medium and by the manometric study. It was found that complications were related to tightness and duration of the banding. In conclusion, we would recommend a loose banding to the extent of "wrapping" and a short duration of the banding within two months.
日本小児外科学会の論文
1992-02-20