Foregut Duplication Cyst Associated with Esophageal Atresia—One-Stage Neonatal Surgical Repair

Spataru, Radu Iulian; Popoiu, Marius Calin; Ivanov, Monica

doi:10.1007/s12262-014-1122-6

Cited by 11 publications

(7 citation statements)

References 9 publications

(17 reference statements)

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“…The second milestone of H-TOF surgery is its intraoperative identification. In extremely rare cases, but possible as previously reported, the fistula may be associated with a duplication cyst which may enable difficulty in its identification and dissection (26). We discussed this above along with the advantages of tracheobronchoscopy.…”

Section: Discussionmentioning

confidence: 82%

Practical safety in the diagnosis and treatment of congenital isolated tracheoesophageal fistula

et al. 2021

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The rareness of H-type tracheoesophageal fistula in conjunction with its unspecific clinical presentation and wide range of anatomical presentation makes its diagnosis and treatment a problematic topic for both ear, nose and throat (ENT) specialists and pediatric surgeons worldwide. Symptoms and clinical signs of H-TOF are easily misleading. Diagnostic methods, most of the times, are dependent on the physician's experience; therefore, various errors may be made. We analyzed our experience in managing H-TOF cases over the last 15 years. Advice and strategies of action for health professionals directly involved in the diagnosis and treatment were identified, but also errors and mistakes while managing 6 cases. We analyzed 'red flags' but also important steps in the practical safety concerning this rare congenital malformation. Choosing the surgical access for division of the fistula throughout the cervical or thoracic approach is sometimes difficult. A scrupulous perioperative planning is mandatory. A dynamic overview of the patient's presentation never underestimating the subtlety of H-TOF presentation should be conducted for its early recognition and achieving best outcomes.

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Section: Discussionmentioning

confidence: 82%

Practical safety in the diagnosis and treatment of congenital isolated tracheoesophageal fistula

et al. 2021

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“…The results of the current research uncovered that there were noticeably more cases of postoperative vascular embolism and anaemia in the control group than those in other experimental groups, which indicated that TXA was safe and feasible for surgical application, and also did not increase the risk of concurrent vascular embolism events [25]. However, the number of patients in the S4 group with complicated vascular embolism was markedly higher than that in the S1, S2 and S3 groups, which reflected that the high dose of TXA administered at 60 mg/kg bw may lead to the risk of postoperative complicated vascular embolism [25][26][27][28]. Also, plasma levels of TNF-α, IL-1, IL-6 and IL-8 were compared before and after the operation in the S2 group and the control group, and it was disclosed that the levels of TNF-a, IL-1, IL-6 and IL-8 in the S2 group were significantly decreased compared with those in the control group (p < 0.05), which indicated that TXA had an antiinflammatory effect on different stages of the systemic inflammatory response induced by surgery, possibly because TXA can indirectly play an anti-inflammatory role by protecting inflammation-related PTs [27].…”

Section: Peripheral Blood Mononuclear Cells (Pbmcs) Expression In the S2 Group And D0 Groupmentioning

confidence: 89%

Application of Tranexamic Acid for the Perioperative Period of Patients Undergoing Scoliosis Correction Surgery

Li¹

2020

FARMACIA

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This study aimed to investigate the efficacy of tranexamic acid (TXA) for the perioperative period of patients undergoing scoliosis correction surgery. 355 patients with scoliosis who were admitted to The Second Affiliated Hospital of Jiamusi University, China, from January 30, 2017, to January 30, 2019, were randomly divided into five groups: experimental group 1 (S1), experimental group 2 (S2), experimental group 3 (S3), experimental group 4 (S4) and control group (D0). Patients in experimental groups were treated with different doses of TXA (15, 30, 45 and 60 mg/kg bw) intravenously, 30 minutes before surgery and sustained infusion of 15 mg/kg bw/h TXA from the beginning until the end of the operation. Patients in D0 group received 30 mg/kg bw normal saline as control. Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), thrombin time (TT), haemoglobin, platelet (PT), intraoperative blood loss and postoperative drainage volume in all groups were detected before and after the operation. Plasma levels of tumour necrosis factor-α (TNF-α), interleukin-1 (IL-1), IL-6 and IL-8 were measured in S2 group and D0 group before, during and after the operation, and then, postoperative complications were recorded. The results showed that the PT, APTT and TT postoperative levels in D0 group were significantly increased compared with the levels in S2, S3 and S4 groups, and the FIB postoperative level significantly decrease compared with the level in S2, S3 and S4 groups. Postoperative levels of haemoglobin and PT in the D0 group were significantly lower compared with the levels in the S1, S2, S3 and S4 groups. The intraoperative blood loss and postoperative drainage volume in the S1 group were significantly increased compared with the levels from S2, S3 and S4 groups. The dose of 60 mg/kg bw TXA determines an increase of cases with complicated embolism compared with lower doses. The optimal dose of TXA was set at 30 mg/kg bw. The plasma levels of TNF-α, IL-1, IL-6 and IL-8 in S2 group were significantly decreased compared with the control group, indicating that the use of low doses of TXA can effectively reduce perioperative bleeding without increasing the risk of complications. In conclusion, 30 mg/kg bw is the optimal dose of TXA showing anti-inflammatory effects at different stages of the systemic inflammatory response induced by surgery. RezumatAcest studiu a avut ca scop investigarea eficacității acidului tranexamic (TXA) în perioada perioperatorie a pacienților supuși unei intervenții chirurgicale de corecție a scoliozei. 355 de pacienți cu scolioză au fost împărțiți în mod aleatoriu în cinci grupuri: 4 experimentale tratate cu doze diferite de TXA (15, 30, 45 și 60 mg/kgc) intravenos, cu 30 de minute înainte de intervenția chirurgicală și perfuzia susținută cu 15 mg/kgc/h TXA de la începutul până la sfârșitul intervenției. Pacienții din grupul martor au primit 30 mg/kgc soluție de ser fiziologic. Timpul de protrombină (PT), timpul de tromboplastină parțial activat (APTT), fibrinogenul ...

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“…If the cyst content is only evacuated, the left mucosa may lead to hemorrhage and anemia, recurrent pancreatitis, rupture, or malignant degeneration. Enucleation of the duplication of the cyst allows preservation of the esophageal wall length, which is essential in primary esophageal anastomosis [ 14 ]. Gastric duplications are misdiagnosed as cystic tumors of the pancreas [ 15 ] or adrenal gland but with normal tumor markers or in rare cases the ectopic tissue can be a cause of gastrointestinal bleeding.…”

Section: ⧉ Discussionmentioning

confidence: 99%

Alimentary tract duplications in children – a 15 years’ experience

Spataru

Lupuşoru²,

Şerban³

et al. 2021

Rom J Morphol Embryol

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Duplications of the alimentary tract are a diverse and complex spectrum of congenital malformations and can be found anywhere along the digestive tract. The management depends on multiple factors, such as age, location, size, macroscopic aspect, and the associated anomalies. This study reflects a 15-year single surgical team experience. We reviewed medical records of 35 consecutive patients presenting alimentary tract duplications, evaluated and managed between 2004 and 2019. The anatomical distribution included: oral structures (two cases), esophageal (three cases), gastric (three patients), jejunoileal (seven cases), ileocecal (12 cases), colonic (six cases), anorectal (one case), and one case of complex tubular duplication of the terminal ileum and entire colon with two anal openings at the perineum. Four patients had antenatal diagnosis, initially asymptomatic, were followed, after birth, with repeated ultrasound examinations for a medium period of 3.8 months. All cases were managed with open surgery. Excision of the lesion with preservation of the gut integrity could be performed in 28 of the cases, while in six cases, enterectomy followed by digestive anastomosis was required. In one complex caudal duplication syndrome, the duplicated tubular colon was left in place. The postoperative complications were gastroesophageal reflux disease (GERD) (two cases), Claude Bernard-Horner syndrome (one case), wound infection (one case), and in one case, massive tongue edema. Clinical findings may be misleading, imaging studies may be uncertain, therefore the surgeon remains to complete de picture with intraoperative findings. In complex duplication cases, a multidisciplinary approach is imperative for the best results.

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Foregut Duplication Cyst Associated with Esophageal Atresia—One-Stage Neonatal Surgical Repair

Cited by 11 publications

References 9 publications

Practical safety in the diagnosis and treatment of congenital isolated tracheoesophageal fistula

Practical safety in the diagnosis and treatment of congenital isolated tracheoesophageal fistula

Application of Tranexamic Acid for the Perioperative Period of Patients Undergoing Scoliosis Correction Surgery

Alimentary tract duplications in children – a 15 years’ experience

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