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The treatment of congenital pyriform sinus fistula: a single-center experience

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Abstract

Purpose

Congenital pyriform sinus fistula (CPSF) often presents diagnosis and treatment challenges. This study aimed to explore the treatment principles and to evaluate the effectiveness of the hypothermia plasma cauterization with suspension laryngoscopy for CPSF.

Methods

The medical records of 56 patients with CPSF from January 2000 to December 2019 were retrospectively reviewed.

Results

Of the 56 cases, the lesions were predominantly located on the left side (95%), and the accuracy of the first diagnosis was 30%. Ultrasound showed an abnormal rate of 86%, while CT or MRI displayed an abnormal anatomic lesion of 92%. The 3D visual reconstruction enabled the analysis of morphological characteristics of CPSF. The positive predictive value of barium esophagography was 89%, whereas the positive rate of the internal opening in CPSF under local anesthesia laryngoscopy was 33%. Nine cases of sinus type underwent open resection, and the recurrence rate was 33%. Interestingly, ten patients with sinus type underwent hypothermia plasma cauterization with suspension laryngoscopy, leading to a success rate of 100% without apparent complications.

Conclusions

Hypothermia plasma cauterization with suspension laryngoscopy alongside 3D imaging is both minimally invasive and repeatable with neglectable complications, which has the potential to serve as the first-line treatment for CPSF in the future.

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Acknowledgements

We thank everyone who participated in this study or helped with its promotion.

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Authors and Affiliations

  1. Department of Pediatric Surgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang Province, China

    Liguang Xia, Zhengxiu Lin, Xiaokun Lin, Yongbiao Wang, Libin Zhu, Jinhan Lin, Yiming Zhao & Zhongrong Li

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  1. Liguang Xia
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  2. Zhengxiu Lin
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  3. Xiaokun Lin
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  4. Yongbiao Wang
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  5. Libin Zhu
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  6. Jinhan Lin
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  7. Yiming Zhao
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  8. Zhongrong Li
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Correspondence to Liguang Xia or Zhongrong Li.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the ethics committee of The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in this study.

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Xia, L., Lin, Z., Lin, X. et al. The treatment of congenital pyriform sinus fistula: a single-center experience. Pediatr Surg Int 36, 779–788 (2020). https://doi.org/10.1007/s00383-020-04676-2

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  • DOI: https://doi.org/10.1007/s00383-020-04676-2

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