scholarly journals Trans-anastomotic tube in esophageal atresia with trachea-esophageal fistula repair: how beneficial are they?

2021 ◽  
Vol 9 (10) ◽  
pp. 2946
Author(s):  
Pradeep Gupta ◽  
Vikram Singh Mujalde
Keyword(s):  
Anastomotic Leak ◽  
Esophageal Atresia ◽  
Tube Feeding ◽  
Feeding Tube ◽  
Developing Nations ◽  
Esophageal Fistula ◽  
Early Feeding ◽  
Early Complications ◽  
Fistula Repair ◽  
Operative Complications

Background: Congenital esophageal atresia with tracheo-esophageal fistula is a common congenital anomaly facing at our centre. There is various proposed anastomotic technique to avoid post-operative complications. In our center, feeding has been conventionally initiated after a contrast esophagogram done at the seventh day post repair. The current study tried to assess the benefits and risks of initiation of early feeding in these patients by placement of a Tran’s anastomotic feeding tube during the repair.Methods: Twenty-five patients had a trans anastomotic feeding tube inserted during trachea esophageal fistula repair and were followed up for different outcomes.Results: Twenty-five patients were operated out of which were sixteen males and nine were females. Early complications of esophageal atresia surgery such as anastomotic leak, surgical site infection, pneumonia and sepsis occur in eight patients. All the complications were managed successfully conservatively, however, one patient died due to anastomotic leak and subsequent septicemia.Conclusions: We conclude that early tube feeding is safe and does not increase risks of anastomotic leaks. It also reduces the need of total parenteral nutrition bringing down the costs of procedure in developing nations.   

scholarly journals Clinical profile of new borns with trachea-esophageal fistula and esophageal atresia and factors associated with outcome at a tertiary care centre

2021 ◽  
Vol 7 (3) ◽  
pp. 140-144
Author(s):  
Keerthidarshini ◽  
Sandeep R ◽  
Gopalkrishna Shanbag
Keyword(s):  
Anastomotic Leak ◽  
Esophageal Atresia ◽  
Clinical Profile ◽  
Common Complication ◽  
Esophageal Fistula ◽  
Female Ratio ◽  
Factors Associated ◽  
Post Operative Period ◽  
Type Of Surgery ◽  
Associated Abnormalities

Although trachea-esophageal fistula (TEF) and esophageal atresia (EA) is rare, it is one of the most common congenital anomaly. There is paucity of data due to rarity of condition. More and more data on clinical profile, complications, and outcome are needed to guide the future research. To study clinical profile of newborns with TEF and EA and factors associated with outcome.Hospital based prospective study was carried out among 21 newborns with TEF and EA. Diagnosis was confirmed by investigations like X-ray chest after passing nasogastric catheter. Depending upon final diagnosis type of surgery required was determined and procedure was carried out as per the standard guidelines and operating techniques. All cases were followed till the complete post-operative period and the complications and outcome was assessed. Outcome was classified as death or discharge.Males outnumbered females giving a male to female ratio of 2.5:1. 57.1% did not require ventilator pre-operatively. 61.9% of the cases had no associated abnormality. The most common type of surgery required and performed was tracheoesophageal repair in 52.4% of the cases. Two cases (9.5%) died during the post-operative period. 14 cases (66.7%) recovered and were discharged. Most common complication was anastomotic leak (57.1%). Term status and associated abnormalities were not found to be associated with outcome like death (p>0.05). Trachea-esophageal fistula and esophageal atresia was more common in males. Tracheoesophageal repair was commonly required surgery. Recovery rate was good. Anastomotic leak was most common complication. Outcome like death was not associated with term status and associated abnormalities.

scholarly journals MODIFIED DUHAMEL PROCEDURE;

2018 ◽  
Vol 25 (08) ◽  
pp. 1147-1150
Author(s):  
Muhammad Afzal Mirza ◽  
Mohsin Riaz Askri ◽  
Shumyala Maqbool ◽  
Sarfraz Ahmad
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Intestinal Obstruction ◽  
Anastomotic Leak ◽  
Early Complications ◽  
Burst Abdomen ◽  
Early Postoperative Complications ◽  
Operative Complications ◽  
Duhamel Procedure ◽  
Complications Rate

Objectives: To evaluate the early complications of Martin’s Modified DuhamelProcedure. Design: Retrospective study. Period: January 2017–December 2017. Setting: TheChildren Hospital & Institute of Child Health, Faisalabad. Material and Methods: This studyincluded Eighty Six children who underwent Martin’s modification of Duhamel’s procedure fortreatment of Hirschsprung’s disease. Results: Early postoperative complications (with in 1st 30days of operation) were observed in 86 patients. The complications noted were bleeding (n=3),wound infection (n=20), burst abdomen (n=5), anastomotic leak (n=8), intestinal obstruction(n=4), early post-operative constipation (n=6), enterocolitis (n=6), soiling (n=5) and mortality(n=2). Conclusion: Early post-operative complications in the series included bleeding, woundinfection, burst abdomen, anastomotic leak, intestinal obstruction, constipation, enterocolitis,soiling and death. The complications rate in this study is comparable to the previous studies.

scholarly journals P82 NUn score validation at a district general hospital

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Jacob Rapier ◽  
Steven Hornby ◽  
Jacob Rapier
Keyword(s):  
Positive Predictive Value ◽  
Anastomotic Leak ◽  
Confidence Intervals ◽  
Predictive Value ◽  
External Validation ◽  
District General Hospital ◽  
Anastomotic Leaks ◽  
Upper Gi ◽  
Increased Risk ◽  
Operative Complications

Abstract Introduction The NUn score was created to try and predict the risk of anastomotic leak or major complications (using the Clavien- Dindo classification) from upper GI resections with an oesophageal anastomosis. A score of > 10 was used to predict an increased risk. In this study we attempt validation. Methods A database of 101 patients was studied, who underwent an Oesophagectomy for cancer between March 2017 and 2020. 72 patients had complete Post-operative day 4 bloods, needed to calculate the score. These patients were then studied for post-operative complications. Results A total of 12 patients had a NUn score of > 10 (16.67%). There was 1 death (1.37%) and 11 anastomotic leaks (15.28%). Of these the NUn score did not predict the death and predicted 8 of the 11 anastomotic leaks. From our data Conclusion From our analysis the NUNs score cannot be shown to be sensitive, specific or have useful positive predictive value. The average Nun score was not reliable, with confidence intervals crossing 10. There may be some merit in using the test for its negative predictive value, but further analysis into this is needed. The results of this audit are consistent with previous efforts at external validation.

Esophageal atresia and tracheo-esophageal fistula

2017 ◽  
Vol 26 (2) ◽  
pp. 67-71 ◽  
Author(s):  
David C. van der Zee ◽  
Stefaan H.A. Tytgat ◽  
Maud Y.A. van Herwaarden
Keyword(s):  
Esophageal Atresia ◽  
Esophageal Fistula

Blenderized Tube Feeding and Enterostomy Tube Occlusions Among Adults with Amyotrophic Lateral Sclerosis and Primary Lateral Sclerosis

2021 ◽  
pp. 1-4
Author(s):  
Claire Kariya ◽  
Lisa Vardi
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Perceived Risk ◽  
Tube Feeding ◽  
Feeding Tube ◽  
Nutrition Support ◽  
Primary Lateral Sclerosis ◽  
Swallowing Difficulties ◽  
Enterostomy Tube ◽  
Primary Lateral ◽  
Lateral Sclerosis

Adults with amyotrophic lateral sclerosis (ALS) and primary lateral sclerosis (PLS) may develop swallowing difficulties and elect to receive an enterostomy feeding tube for nutrition support. Blenderized tube feeding (BTF) appeals to those interested in a homemade enteral nutrition option, but there are concerns of feeding tube occlusion and limited research on this potential risk. Therefore, our purpose was to determine the frequency of, and risk factors for, feeding tube occlusions among adults with ALS or PLS who use BTF. For this retrospective study, the electronic medical records of tube-fed adults with ALS or PLS who received outpatient care at a provincial ALS clinic during a two-year period were reviewed (n = 651). There were 97 tube-fed patients identified, of which 20 (21%) used BTF. Average duration of BTF use was 11.25 ± 7.5 months. Seven subjects (35%) used BTF exclusively, while 13 (65%) used a combination of BTF and commercial enteral formula. All received BTF by gastrostomy tube, sized 14 to 24 French. BTF administration methods and compliance with water flush recommendations varied. Despite the perceived risk of feeding tube occlusions with blenderized tube feeding, no occlusions were found to have occurred in this study.

TRACHEO-ESOPHAGEAL FISTULA WITHOUT ESOPHAGEAL ATRESIA—CONGENITAL AND RECURRENT

PEDIATRICS ◽  
1956 ◽  
Vol 18 (6) ◽  
pp. 935-942
Author(s):  
William K. Sieber ◽  
Bertram R. Girdany
Keyword(s):  
Aqueous Solution ◽  
Esophageal Atresia ◽  
Early Recognition ◽  
Esophageal Fistula ◽  
Clinical Problems

The clinical problems presented by 10 infants with congenital and recurrent tracheo-esophageal fistulas are discussed. A roentgenographic technique of identification of tracheo-esophageal fistulas, using the aqueous solution Dionosil®, is described. The intermittent patency of the fistula is stressed. Recurrent tracheo-esophageal fistula may be a complication in infants operated upon for esophageal atresia with tracheo-esophageal fistula. The results in this series demonstrate the urgency of early recognition and prompt therapy.

Esophageal atresia and tracheo-esophageal fistula

2003 ◽  
pp. 337-352 ◽  
Author(s):  
Paul Losty ◽  
Colin Baillie
Keyword(s):  
Esophageal Atresia ◽  
Esophageal Fistula

scholarly journals Managing Eating Disorders in Elderly with Dementia and the Ethical Considerations for Tube Feeding

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Quality Of Life ◽  
Eating Disorders ◽  
Management Strategies ◽  
Tube Feeding ◽  
The Elderly ◽  
Feeding Tube ◽  
Medical Complications ◽  
Ethical Considerations ◽  
Nutritional Needs

As dementia progresses, the elderly with dementia often have difficulties finishing their meals and weight loss is a common feature at this stage of their dementia journey. Eating disorders cause tremendous caregiver stress and burden. In considering provision of best care for this group of elderly, the hospital is probably not the best place and yet, they are frequently brought in to the hospital to seek help for fever, pneumonia, dislodged feeding tube, medical complications arising from poor feeding and dehydration. It is important to understand the aetiology of poor feeding among this group of patients and advise the patients and their family on the appropriate management strategies to improve the intake of food and to maximize their quality of life. At this stage of dementia, focusing on means to ensure nutritional needs are met may end up causing further harm and distress.

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