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KMID : 0375219980130000013
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Journal of Il Sin Christian Hospital
1998 Volume.13 No. 0 p.13 ~ p.26
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Esophageal Atresia and Tracheoesophageal Fistula in Korea - A national Survery of its Members by the Korean Association of Pediatric Surgeons -
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Park Woo-Hyun
Kwon Soo-In
Kim Seong-Cheol
Kim Shin-Gon
Kim Woo-Ki
Kim In-Gu
Kim Jai-Eok
Kim Hyun-Hahk
Park Kwi-Won
Park Young-Sik
Song Young-Tack
Yang Jung-Woo
Oh Soo-Myung
Yoo Su-Young
Lee Doo-Sun
Lee Myung-Duk
Lee Sung-Cheol
Lee Suk-Koo
Lee Tae-Seok
Chang Soo-Il
Chun Si-Youl
Chung Eul-Sam
Jung Sang-Young
Jung Sung-Eun
Jung Poong-Man
Cho Ma-Hae
Joo Jong-Soo
Chio Soon-Ok
Choi Seung-Hoon
Heo Young-Soo
Hong Jeong
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Abstract
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The First national survey on esophageal atresia and tracheoesophageal fistula was conducted to access the current status of its incidence, clinical manifestation, preperative diagnosis and management, type of its anomaly, associated anomalies, and surgical results and course. The 43 members of the Korea associated of Pediatric Surseons received questionnaires and registration forms to be filled out on each patient who were born during the three years from January 1, 1992 through December 31, 1994. Questionnaires composed of six broad areas which include 1) preoperative diagnosis and management, 2) surgical technic, 3) long gap, 4) postoperative management, and 5) complications and courses. A total of 148 cases was returned by 28 members working at 23 insitution and 27 members returned questionnaires. We obtained the following results by analysis of the 148 cases of tracheoesophageal anomalies. The incidence of tracheoesophageal anomaly was about 1/10,000-11,000 in 1994, which is one third of that of ancrectal malformations in Korea and the distributin of the patients was almost proportionate to the size of each province. Both sexes are about equally affected. Majouity of the members make diagnosis of tracheoesophageal anomaly by taking a simple infantogram with a radiopaque tube in upper pouch and a little under half(48%) prefers to perform echocardiography as a part of preperative management to identify congenital heart disease and lateralize the aorta.
Esophageal atresia with distal TEF(87.5%) was by far the most commom and threre were pure esopahgeal atresia(5.6%), H-type TEF(2.1%), and so on. About half(49%) of the patients had one or more associated anomalies in 15cases(10%), genitourinary anomalies in 10 cases(7%) and gastrointestinal anomalies in 7 cases(5%). Postoperatively, psrenteral nutrition and assisted ventilation were given in 66% and 52% of pareients respectively. Ninety three(74%) of 126 cases whounderwent sugical procedure,
experienced one or more complications such as respiratory complication(65%), leak(22%), stricture(21%) and so on. The surviral rates related to the Waterston risk categories were 90.2% in grpup A, 71.4-95% in B1, B2 and C1 groups, and 28% in group C2 and the overall survuval rate was 71.4%. Thirty six(28.6%) of 126 cases died of pneumonia/sepsis(12 cases), respiratoty failure(12 cases), and congenital heart disease(4 cases). With short term follow-up, 69% of patients have been excellent whereas remainders of the cases have suffered from some sort of morvidity related to gastroesophageal reflux, recurrent respiratory infection, and esophageal stricure.
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KEYWORD
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Esophageal atresia, Tracheoesophageal fistula, National survey, Korea,
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