Ⅲ型先天性食管闭锁胸腔镜手术治疗后吻合口狭窄的影响因素分析OA北大核心CSCDCSTPCD

Objective To explore the influencing factors of anastomotic stricture after thoracoscopy in children with type Ⅲ congenital esophageal atresia(CEA).Methods A retrospective analysis was conducted for clinical data of 33 children with type Ⅲ CEA undergoing thoracoscopy at Guangzhou Women & Children's Medical Center from January 2017 to January 2021.Patients with dysphagia requiring balloon dilatation during follow-ups were categorized into stricture group while those without these complications were assigned into non-stricture group.Potential influencing factors such as gender,weight,gestational age,gap length and anastomotic leakage were examined for determining their association with postoperative anastomotic stricture.Result-s Among them,7 cases developed anastomotic stricture.Univariate analysis indicated that postoperative gastroe-sophageal reflux(x2=6.046,P=0.014)and anastomotic leakage(x2=7.757,P=0.005)were significantly associated with anastomotic stricture after thoracoscopy(P＜0.05).Multivariate stepwise Logistic regression a-nalysis identified anastomotic leakage(OR=19.167,95％CI:2.868-189.764,P=0.004)as an independent risk factor for postoperative anastomotic stricture in CEA children(P＜0.05).Conclusions Anastomotic leakage is an independent risk factor for anastomotic stricture after thoracoscopic repair of type Ⅲ CEA.Optimi-zing surgical techniques and postoperative managements for preventing anastomotic leakage is crucial for enhan-cing postoperative quality-of-life in type Ⅲ CEA children.