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Abstract：
UNASSIGNED: Tracheal agenesis (TA) is rare and usually fatal. Few survivors with concomitant tracheoesophageal fistulae (TEF) who underwent ligation of the distal esophagus with creation of a spit-fistula and neo-trachea from the proximal esophagus exist. We report a novel surgical technique whereby the esophagus is divided longitudinally to preserve a functional alimentation tract and a parallel neo-trachea. We review the literature of reported cases, including survivors beyond 12 months.
UNASSIGNED: Case report and literature review.
UNASSIGNED: A female infant with prenatal polyhydramnios was born at 35 weeks gestation with immediate respiratory distress and absent cry. Oxygenation was maintained with a laryngeal mask airway. Despite a normal appearing larynx, she could not be intubated and emergent neck exploration disclosed no cervical trachea. The patient was placed on extra corporeal membranous oxygenation (ECMO), and later diagnosed with TA, Floyd Type I. Parental desire for reconstruction but refusal of a spit-fistula necessitated a novel procedure. The esophagus was divided longitudinally via a microstapler to preserve the original alimentary tract and create a parallel neo-trachea originating from the TEF and terminating as a cervical stoma. The healing process was complicated but the baby was ultimately discharged to home where she developed normally neurologically until succumbing one night to accidental decannulation at 16 months of age.
UNASSIGNED: We describe a novel surgical approach to manage TA. This includes avoiding creation of a spit fistula and preserving the native esophagus. We then survey the literature, reporting the survivorship duration and operative management of 174 reported cases of TA.
UNASSIGNED: Case report and literature review.
UNASSIGNED: A female infant with prenatal polyhydramnios was born at 35 weeks gestation with immediate respiratory distress and absent cry. Oxygenation was maintained with a laryngeal mask airway. Despite a normal appearing larynx, she could not be intubated and emergent neck exploration disclosed no cervical trachea. The patient was placed on extra corporeal membranous oxygenation (ECMO), and later diagnosed with TA, Floyd Type I. Parental desire for reconstruction but refusal of a spit-fistula necessitated a novel procedure. The esophagus was divided longitudinally via a microstapler to preserve the original alimentary tract and create a parallel neo-trachea originating from the TEF and terminating as a cervical stoma. The healing process was complicated but the baby was ultimately discharged to home where she developed normally neurologically until succumbing one night to accidental decannulation at 16 months of age.
UNASSIGNED: We describe a novel surgical approach to manage TA. This includes avoiding creation of a spit fistula and preserving the native esophagus. We then survey the literature, reporting the survivorship duration and operative management of 174 reported cases of TA.
摘要：
■气管发育不全（TA）很少见，通常是致命的。很少有合并气管食管瘘（TEF）的幸存者接受了远端食道结扎，并从近端食道产生吐痰瘘和新气管。我们报告了一种新颖的手术技术，其中将食道纵向分开以保留功能性营养道和平行的新气管。我们回顾了报告病例的文献，包括12个月以上的幸存者.
■病例报告和文献复习。
■一名产前羊水过多的女婴在妊娠35周时出生，立即出现呼吸窘迫和无哭闹。用喉罩气道维持氧合。尽管喉部表现正常,她无法插管，紧急颈部探查显示没有颈部气管。患者接受了体外膜氧合（ECMO）治疗，后来被诊断为TA，弗洛伊德I型。父母对重建的渴望，但拒绝吐痰瘘需要一种新颖的手术。食道通过微型吻合器纵向分开，以保留原始消化道，并创建一个平行的新气管，该气管起源于TEF并终止为子宫颈造口。愈合过程很复杂，但婴儿最终出院回家，在那里她的神经系统发育正常，直到一个晚上在16个月大的时候因意外拔管而屈服。
■我们描述了一种新的治疗TA的手术方法。这包括避免产生吐痰瘘和保留天然食道。然后我们调查文献，报告174例报告的TA的生存时间和手术管理。
■病例报告和文献复习。
■一名产前羊水过多的女婴在妊娠35周时出生，立即出现呼吸窘迫和无哭闹。用喉罩气道维持氧合。尽管喉部表现正常,她无法插管，紧急颈部探查显示没有颈部气管。患者接受了体外膜氧合（ECMO）治疗，后来被诊断为TA，弗洛伊德I型。父母对重建的渴望，但拒绝吐痰瘘需要一种新颖的手术。食道通过微型吻合器纵向分开，以保留原始消化道，并创建一个平行的新气管，该气管起源于TEF并终止为子宫颈造口。愈合过程很复杂，但婴儿最终出院回家，在那里她的神经系统发育正常，直到一个晚上在16个月大的时候因意外拔管而屈服。
■我们描述了一种新的治疗TA的手术方法。这包括避免产生吐痰瘘和保留天然食道。然后我们调查文献，报告174例报告的TA的生存时间和手术管理。
