Year 2022 Vol. 30 No 3

PEDIATRIC SURGERY

M.A. AKSELROV 1, 2, S.N. SUPRUNETS 1, 2, .V. SERGIENKO 2, D.I. SUDAREVA 2, A.V. TANZYBAEV 2, V.. EMELYANOVA 1, 2

SUCCESSFUL USE OF INTRATHORACIC THORACOSCOPIC TRACTION ELONGATION OF THE ESOPHAGUS FOLLOWED BY DELAYED ANASTOMOSIS AND LAPAROSCOPIC LEDDS OPERATION IN A NEONATE WITH MULTIPLE MALFORMATIONS

Tyumen State Medical University 1,
Regional Clinical Hospital 2 2, Tyumen,
Russian Federation

Esophageal atresia is a malformation with an incidence of 1: 2500-1: 3000 newborns. Duodenal obstruction occurs in 1: 7000-10000 neonates. The combination of congenital esophageal atresia and duodenal obstruction is less frequent than 1-6% of all cases of esophageal atresia. The article is devoted to the choice of treatment tactics of a neonate with a rare combination of gastrointestinal malformations: esophageae without associated tracheoesophageae fistula atresia of type A (R. Gross classification) and duodenal obstruction caused by a violation of intestinal rotation and fixation. The variability of surgical approaches is shown and the technique of intrathoracic thoracoscopic tractional elongation of the esophagus is demonstrated, which allowed perfoming esophago-esophagoanastomosis in 10 days thoracoscopically and preserve the childs esophagus. The uniqueness of the case is that laparoscopy was performed simultaneously with the primary esophageal surgery, aimed at eliminating the midgut volvulus which caused high intestinal obstruction. Gastrointestinal passage was fully restored 14 days after the second stage of esophageal plastic surgery. Subsequently, stenosis was recorded in the place of esophageal anastomosis, resolved by esophageal bougienage conducted by string-guide under esophagoscopy control. The chosen endoscopic treatment of the correction of combined malformations of the gastrointestinal tract allowed saving the childs esophagus and discharging him to out-patient observation in a satisfactory condition.

Keywords: esophageal atresia, duodenal obstruction, Ledds syndrome, intestinal malrotation, thoracoscopy, laparoscopy, malformations, anastomosis, internal traction, long-gap
p. 264-269 of the original issue
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Address for correspondence:
625039, Russian Federation,
Tyumen, st. Melnikayte, 75 bldg. 2,
Regional Clinical Hospital No. 2,
Department of Anesthesiology,
Resuscitation and Intensive Care,
Tel. +7 912 997 01 82,
e-mail: novostruevadaniela@gmail.com,
Sudareva Daniela I.
Information about the authors:
Akselrov Mikhail A., MD, Head of the Department of Pediatric Surgery, Tyumen State Medical University, Head of the Surgical Department No. 1, Regional Clinical Hospital No. 2, Tyumen, Russian Federation.
https://orcid.org/0000-0001-6814-8894
Suprunets Svetlana N., PhD, Associate Professor of the Department of Childrens Diseases, Tyumen State Medical University, Head of the Department of Anesthesiology, Resuscitation and Intensive Care of Newborns, Regional Clinical Hospital No. 2, Tyumen, Russian Federation.
https://orcid.org/0000-0001-8579-1857
Sergienko Tatyana V., Pediatric Surgeon, Regional Clinical Hospital No. 2, Tyumen, Russian Federation.
https://orcid.org/0000-0003-3338-1260
Sudareva Daniela I., Neonatologist, Department of Anesthesiology, Resuscitation and Intensive Care of Newborns, Regional Clinical Hospital No. 2, Tyumen, Russian Federation.
https://orcid.org/0000-0001-5956-0385
Tanzybaev Anton V., Anesthesiologist, Department of Anesthesiology, Resuscitation and Intensive Care of Newborns, Regional Clinical Hospital No. 2, Tyumen, Russian Federation.
https://orcid.org/0000-0003-1320-2798
Emelyanova Victoria Alexandrovna, Head of the Medical Care Service for Children Regional Clinical Hospital No. 2, Assistant of the Department of Pediatric Surgery, Tyumen State Medical University, Tyumen, Russian Federation.
https://orcid.org/0000-0002-9857-9174
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