COMPLICATIONS IN THE POSTOPERATIVE LONG-TERM AFTER PRIMARY PLASTY OF ESOPHAGEAL ATRESIA

Objective. To analyze and systematize modern data of foreign literature in recent years on the diagnosis, treatment and rehabilitation of patients after primary esophagoplasty for atresia in the long-term.

The improvement of surgical methods of correction, as well as advances in neonatal intensive care have improved the results of treatment of this pathology, which has led to an increase in the survival rate of newborns, which currently exceeds 90 %. At the current stage of surgery the operation of choice in the absence of severe malformations is the primary application offend-to-end anastomosis between two segments of the esophagus. In the presence of insurmountable diastasis between segments the esophagus is restored in several stages: application of cervical esophagostomy with further performance of delayed anastomosis or creation of artificial esophagus. Various methods of lengthening esophageal segments for direct anastomosis are also used.

Therefore, in recent years, the focus of pediatric surgeons has been on early and late complications arising after successful primary esophageal atresia plastic surgery, at the same time the number of studies examining the effects of long-term exposure to these complications at an early age in adult patients is increasing. The main complications arising in the postoperative period of primary esophageal plastic surgery are: anastomotic dehiscence, esophageal stenosis in the anastomosis zone, gastroesophageal reflux, disorders of esophageal motility, dysfagy, eosinophilic esophagitis, Barrett esophagus. Complications in the long-term are a complex and unexplored problem after primary esophagoplasty.

Conclusion. Patients with esophageal atresia after esophago-esophagoanastomosis do not have full recovery esophageal function. The significant incidence of various complications after primary esophageal plasty, which is observed in these patients, prompts pediatric surgeons to search for new methods of early diagnosis, treatment and prevention of esophageal dysfunction. Further research is needed to develop a more effective strategy to help detect complications early, which can help in the rehabilitation and social adaptation of these patients.

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Автор(ы): A. S. Belavokaya, V. I. Averin, A. I. Bolotnik