PDF(Pubmed)
Abstract：
UNASSIGNED: Anastomotic leak after primary repair of esophageal atresia (EA) with tracheoesophageal fistula (TEF) is a well-known complication and can represent a challenging clinical scenario.
UNASSIGNED: The present study aimed to evaluate the role of glycopyrrolate as an adjunct in the treatment of anastomotic leak after primary repair of EA Vogt type 3b.
UNASSIGNED: A retrospective study was carried out in our tertiary care teaching institute from January 2015 to December 2022.
UNASSIGNED: Neonates with EA with distal TEF with primary repair who had developed anastomotic leak, managed by the author(s), were studied. The study included patients with major, minor, and radiological leaks. Glycopyrrolate was administered in the dose of 4 μg/kg 8 hourly. The outcomes of the study were either resolution or progression of the leak.
UNASSIGNED: There were 21 patients who were managed with glycopyrrolate in addition to the classical treatment of the anastomotic leak following repair of EA with distal TEF. The male: female ratio was 1:1.1. All the cases had anastomotic leaks with either clinically detectable in the chest tube (15) or radiological leak (6). The leaks were detected early in patients with major leak (mean = 3.2 ± 0.84 days) compared to minor leak (mean =4.9 ± 1.29 days). Radiological leaks were detected in all the neonates on postoperative day 7. In five patients with major leak, there was a negligible reduction in the amount of chest tube output, and were subjected to diversion procedures. There were a total of three deaths out of five in this group. In 10 patients with minor leak, there was complete resolution of anastomotic leak in eight patients (80%); there was one patient each with mortality and diversion procedure. The patients with a radiological leak (6) did not show any deterioration, and they were fed 1-5 days after the esophagogram.
UNASSIGNED: Glycopyrrolate may be an advantageous postoperative adjunct in the management of minor and radiological leak after tracheoesophageal repair.
UNASSIGNED: The present study aimed to evaluate the role of glycopyrrolate as an adjunct in the treatment of anastomotic leak after primary repair of EA Vogt type 3b.
UNASSIGNED: A retrospective study was carried out in our tertiary care teaching institute from January 2015 to December 2022.
UNASSIGNED: Neonates with EA with distal TEF with primary repair who had developed anastomotic leak, managed by the author(s), were studied. The study included patients with major, minor, and radiological leaks. Glycopyrrolate was administered in the dose of 4 μg/kg 8 hourly. The outcomes of the study were either resolution or progression of the leak.
UNASSIGNED: There were 21 patients who were managed with glycopyrrolate in addition to the classical treatment of the anastomotic leak following repair of EA with distal TEF. The male: female ratio was 1:1.1. All the cases had anastomotic leaks with either clinically detectable in the chest tube (15) or radiological leak (6). The leaks were detected early in patients with major leak (mean = 3.2 ± 0.84 days) compared to minor leak (mean =4.9 ± 1.29 days). Radiological leaks were detected in all the neonates on postoperative day 7. In five patients with major leak, there was a negligible reduction in the amount of chest tube output, and were subjected to diversion procedures. There were a total of three deaths out of five in this group. In 10 patients with minor leak, there was complete resolution of anastomotic leak in eight patients (80%); there was one patient each with mortality and diversion procedure. The patients with a radiological leak (6) did not show any deterioration, and they were fed 1-5 days after the esophagogram.
UNASSIGNED: Glycopyrrolate may be an advantageous postoperative adjunct in the management of minor and radiological leak after tracheoesophageal repair.
摘要：
■初次修复食管闭锁（EA）伴气管食管瘘（TEF）后的吻合口漏是一种众所周知的并发症，可以代表具有挑战性的临床情况。
■本研究旨在评估格隆溴铵作为辅助治疗EAVogt3b型初次修复后吻合口漏的作用。
■于2015年1月至2022年12月在我们的三级护理教学机构进行了一项回顾性研究。
■出现吻合口漏的经远端TEF初次修复的EA新生儿，由作者管理，被研究过。该研究包括患有重大疾病的患者，未成年人,和放射性泄漏。格隆溴铵以4μg/kg的剂量每8小时给药。研究的结果是渗漏的消退或进展。
■有21例患者在使用远端TEF修复EA后，除了经典治疗吻合口漏外，还使用格隆铵治疗。男女比例为1:1.1。所有病例都有吻合口漏，临床上可在胸管中检测到（15）或放射性泄漏（6）。与轻微泄漏（平均=4.9±1.29天）相比，严重泄漏的患者早期发现泄漏（平均=3.2±0.84天）。术后第7天，所有新生儿均检测到放射学泄漏。在五名严重渗漏的患者中，胸管输出量的减少可以忽略不计，并接受了转移程序。该组共有五分之三死亡。在10个轻微渗漏的患者中，8例患者(80%)吻合口漏完全缓解;各有1例患者死亡和分流手术.放射学泄漏的患者（6）没有表现出任何恶化，他们在食管造影后1-5天进食。
■格隆溴铵可能是治疗气管食管修补后轻微和放射学渗漏的有利术后辅助手段。
■本研究旨在评估格隆溴铵作为辅助治疗EAVogt3b型初次修复后吻合口漏的作用。
■于2015年1月至2022年12月在我们的三级护理教学机构进行了一项回顾性研究。
■出现吻合口漏的经远端TEF初次修复的EA新生儿，由作者管理，被研究过。该研究包括患有重大疾病的患者，未成年人,和放射性泄漏。格隆溴铵以4μg/kg的剂量每8小时给药。研究的结果是渗漏的消退或进展。
■有21例患者在使用远端TEF修复EA后，除了经典治疗吻合口漏外，还使用格隆铵治疗。男女比例为1:1.1。所有病例都有吻合口漏，临床上可在胸管中检测到（15）或放射性泄漏（6）。与轻微泄漏（平均=4.9±1.29天）相比，严重泄漏的患者早期发现泄漏（平均=3.2±0.84天）。术后第7天，所有新生儿均检测到放射学泄漏。在五名严重渗漏的患者中，胸管输出量的减少可以忽略不计，并接受了转移程序。该组共有五分之三死亡。在10个轻微渗漏的患者中，8例患者(80%)吻合口漏完全缓解;各有1例患者死亡和分流手术.放射学泄漏的患者（6）没有表现出任何恶化，他们在食管造影后1-5天进食。
■格隆溴铵可能是治疗气管食管修补后轻微和放射学渗漏的有利术后辅助手段。
