Abstract
Purpose
This study was designed to evaluate the accuracy of preoperative CT scan in depicting the structure of type C esophageal atresia (EA) and determine its role in planning the surgical strategy by digitally measuring the interpouch distance.
Methods
Thirty-five neonates (20 males, 15 females) born with type C EA were enrolled in this study. A helical CT scan was performed after chest radiographs of the neonates with a coiled oroesophageal tube in the upper esophageal pouch. The interpouch distances measured on CT images were compared with the findings at surgery.
Results
With the use of helical CT scan, the structure of EA-TEF was accurately depicted; the origins of the fistula and the interpouch distance were defined. The interpouch distance detected by CT scan correlated well with the findings at surgery. Statistical analysis demonstrated no significant difference (R = 0.99, P < 0.001). CT scan findings were crucial in planning the surgical strategy in 14 patients (40 %).
Conclusion
Preoperative CT scan could provide more accurate information about the origin of the fistula and the interpouch distance in type C EA and played a crucial role in planning the surgical strategy.
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Puri P, Blake N, O’Donnell B et al (1981) Delayed primary anastomosis following spontaneous growth of esophageal segments in esophageal atresia. J Pediatr Surg 16(2):180–183
Lacher M, Froehlich S, von Schweinitz D et al (2010) Early and long term outcome in children with esophageal atresia treated over the last 22 years. Klin Padiatr 222(5):296–301
Okamoto T, Takamizawa S, Arai H et al (2009) Esophageal atresia: prognostic classification revisited. Surgery 145(6):675–681
Tam PK, Chan FL, Saing H (1987) Diagnosis and evaluation of esophageal atresia by direct sagittal CT. Pediatr Radiol 17(1):68–70
Ratan SK, Varshney A, Mullick S et al (2004) Evaluation of neonates with esophageal atresia using chest CT scan. Pediatr Surg Int 20(10):757–761
Sodhi KS, Aiyappan SK, Saxena AK et al (2010) Utility of multidetector CT and virtual bronchoscopy in tracheobronchial obstruction in children. Acta Paediatr 99(7):1011–1015
Soye JA, Yarr J, Dick AC et al (2005) Multidetector-row computed tomography three-dimensional volume reformatted ‘transparency’ images to define an upper pouch fistula in oesophageal atresia. Pediatr Radiol 35(6):624–626
Siegel MJ (2003) Multiplanar and three dimensional multi-detector row CT of the thoracic vessels and airways in the pediatric population. Radiology 229(3):641–650
Van der Zee DC, Vieirra-Travassos D, de Jong JR et al (2008) A novel technique for risk calculation of anastomotic leakage after thoracoscopic repair for esophageal atresia with distal fistula. World J Surg 32(7):1396–1399
Frush DP (2009) Radiation, CT, and children: the simple answer is…it’s complicated. Radiology 252(1):4–6
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Su, P., Huang, Y., Wang, W. et al. The value of preoperative CT scan in newborns with type C esophageal atresia. Pediatr Surg Int 28, 677–680 (2012). https://doi.org/10.1007/s00383-012-3082-x
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DOI: https://doi.org/10.1007/s00383-012-3082-x