Retrospective analysis of pneumothorax after repair of esophageal atresia/tracheoesophageal fistula

BMC Pediatrics

Jinshi Huang¹  Siqi Li¹  Jiawei Zhao¹  Shen Yang¹  Yanan Zhang¹  Yichao Gu¹  Shuangshuang Li¹  Yong Zhao¹  Junmin Liao¹  Yongwei Chen¹  Peize Wang¹  Kaiyun Hua¹ 

[1] Department of Neonatal Surgery, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, 100045, Beijing, China;

关键词: Esophageal atresia;    Pneumothorax;    Anastomotic leakage;    Mechanical ventilation;   

DOI  :  10.1186/s12887-021-02948-x

来源: Springer

【 摘 要 】

BackgroundTo analyze the possible causes, treatment and outcomes of postoperative pneumothorax in patients with Gross type C esophageal atresia/tracheoesophageal fistula (EA/TEF).MethodsMedical records of patients with Gross type C EA/TEF who were diagnosed and treated in Beijing Children’s Hospital from January 2007 to January 2020 were retrospectively collected. They were divided into 2 groups according to whether postoperative pneumothorax occurred. Univariate and multivariate logistic regression analysis were performed to identify risk factors for pneumothorax.ResultsA total of 188 patients were included, including 85 (45 %) in the pneumothorax group and 103 (55 %) in the non-pneumothorax group. Multivariate logistic regression analysis showed that postoperative anastomotic leakage [P < 0.001, OR 3.516 (1.859, 6.648)] and mechanical ventilation [P = 0.012, OR 2.399 (1.210, 4.758)] were independent risk factors for pneumothorax after EA/TEF repair. Further analysis of main parameters of mechanical ventilation after surgery showed that none of them were clearly related to the occurrence of pneumothorax. Among the 85 patients with pneumothorax, 33 gave up after surgery and 52 received further treatment [conservative observation (n = 20), pleural puncture (n = 11), pleural closed drainage (n = 9), both pleural puncture and closed drainage (n = 12)]. All of the 52 patients were cured of pneumothorax at discharge.ConclusionsAnastomotic leakage and postoperative mechanical ventilation were risk factors for pneumothorax after repair of Gross type C EA/TEF, but the main parameters of mechanical ventilation had no clear correlation with pneumothorax. After symptomatic treatment, the prognosis of pneumothorax was good.

【 授权许可】

CC BY