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선천성 식도 폐쇄증의 예후인자에 대한 임상적 고찰
Prognostic Factor of Congenital Esophageal Atresia선천성 식도 폐쇄증의 예후인자에 대한 임상적 고찰
이대성(Dae Sung Lee),김홍주(Hong Ju Kim),배병노(Byeng No Bae),김기환(Ki Hwan Kim),한세환(Se Hwan Han),김영덕(Young Duk Kim),김홍용(Hong Yong Kim)
UCI I410-ECN-0102-2009-510-004833879
* 발행 기관의 요청으로 이용이 불가한 자료입니다.

Purpose: This study was undertaken in order to analyze clinical data conceming cases of esophageal atresia cases we encountered to elucidate the risk factors that may more accurately predict a prognosis. Methods: We retrospec5vely reviewed the medical charts of 19 infants with esophageal atresia diagnosed at Sanggye Paik Hospital from Juoe 1991 to M8y 2000. Resulte: The mean birth ht of the infants was 2.46 kg (0.97-3.99 kg). Associated anomalies occurred in t2 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 & delayed 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 r8te 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 8, and 9 (47.3%) as group C. The postoperative survival rates of group A, B, and C were 100% (3/3), 80% (4/5), 8Ad 50% (2/4) respectively. The postoperative survival rates of class l and class II by Montreal classification were 88.9%(8/9) and 33.3% (1/3), respectively. Conclusion: Our 4ata suggests that associated anomalies and general conditions are more important prognostic factors than birth weights in patients with esophageal atresia. (J Korean Surg Soc 2001;61:277-281)

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