Özofagus Atrezisi ve Trakeoözofageal Fistül Tanılı Yenidoğanda Anestezi Yönetimi
Özet
Özofagus atrezisi, yaklaşık olarak 4500 doğumda bir oranında görülen, hızlı teşhis, cerrahi müdahale ve tedavi gerektiren multisistemik konjenital anomalidir. Malformasyon, trakeoözofageal fistül ile birlikte olabilir. Anatomik özelliklerine göre beş alt tipe ayrılır. Hastaların %50’sinden fazlasında ek konjenital anomali görülebilmektedir. Tanı çoğunlukla postnatal dönemde konulur. Bebeğin beslenmeyi tolere edememesi, öksürük, boğulma hissi, siyanoz tanıdan şüphelendirir. Kesin tanı yapılan görüntülemelerle konur. Bu hasta grubunda başarılı sonuçlar için dikkatli bir perioperatif yönetim gereklidir. Yenidoğanın klinik özellikleri de anestezi yönetimini zorlaştırmaktadır. Olgu sunumunda dikkat edilmesi gereken birçok özelliği barındıran, multidisipliner yaklaşım gerektiren bu hasta grubunun anestezi yönetiminden bahsetmeyi amaçladık.
Esophageal atresia is a multisystem congenital anomaly that occurs at a rate of approximately 1 in 4500 births, requiring rapid diagnosis, surgical intervention, and treatment. It can be associated with tracheoesophageal fistula. It is divided into five subtypes based on anatomical features. More than 50% of patients may have additional congenital anomalies. Diagnosis is usually made in the postnatal period. Inability to tolerate feeding, coughing, a sensation of choking, and cyanosis may raise suspicion for the diagnosis. Definitive diagnosis is made through imaging studies. Careful perioperative management is required for successful outcomes in this patient group. The clinical features of newborns also make anesthesia management challenging. We aimed to discuss anesthesia management for this patient group, which requires a multidisiplinary approach and attention to many important features, in the case presentation.
Referanslar
Platt JM, Nettel-Aguirre A, Bjornson CL, Mitchell I, Davis K, Bailey JM. Multidisciplinary coordination of care for children with esophageal atresia and tracheoesophageal fistula. J Child Health Care. Published online May 24, 2023. doi:10.1177/13674935231174503 )
Baldwin D, Yadav D. Esophageal Atresia. [Updated 2023 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560848/)
Lee S. Basic Knowledge of Tracheoesophageal Fistula and Esophageal Atresia. Adv Neonatal Care. 2018;18(1):14-21. doi:10.1097/ANC.0000000000000464
Smith N. Oesophageal atresia and tracheo-oesophageal fistula. Early Hum Dev. 2014;90(12):947-950. doi:10.1016/j.earlhumdev.2014.09.012
Kinottenbelt G, Skinner A, Seefelder C. Tracheo-oesophageal fistula (TOF) and oesophageal atresia (OA). Best Pract Res Clin Anaesthesiol. 2010;24(3):387-401. doi:10.1016/j.bpa.2010.02.010
Spitz L. Oesophageal atresia. Orphanet J Rare Dis. 2007;2:24. Published 2007 May 11. doi:10.1186/1750-1172-2-24
van Lennep M, Singendonk MMJ, Dall'Oglio L, et al. Oesophageal atresia [published correction appears in Nat Rev Dis Primers. 2024 Mar 22;10(1):24]. Nat Rev Dis Primers. 2019;5(1):26. Published 2019 Apr 18. doi:10.1038/s41572-019-0077-0
McCann ME, Soriano SG. Progress in anesthesia and management of the newborn surgical patient. Semin Pediatr Surg. 2014;23(5):244-248. doi:10.1053/j.sempedsurg.2014.09.003
Subramaniam R. Anaesthetic concerns in preterm and term neonates. Indian J Anaesth. 2019;63(9):771-779. doi:10.4103/ija.IJA_591_19
Referanslar
Platt JM, Nettel-Aguirre A, Bjornson CL, Mitchell I, Davis K, Bailey JM. Multidisciplinary coordination of care for children with esophageal atresia and tracheoesophageal fistula. J Child Health Care. Published online May 24, 2023. doi:10.1177/13674935231174503 )
Baldwin D, Yadav D. Esophageal Atresia. [Updated 2023 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560848/)
Lee S. Basic Knowledge of Tracheoesophageal Fistula and Esophageal Atresia. Adv Neonatal Care. 2018;18(1):14-21. doi:10.1097/ANC.0000000000000464
Smith N. Oesophageal atresia and tracheo-oesophageal fistula. Early Hum Dev. 2014;90(12):947-950. doi:10.1016/j.earlhumdev.2014.09.012
Kinottenbelt G, Skinner A, Seefelder C. Tracheo-oesophageal fistula (TOF) and oesophageal atresia (OA). Best Pract Res Clin Anaesthesiol. 2010;24(3):387-401. doi:10.1016/j.bpa.2010.02.010
Spitz L. Oesophageal atresia. Orphanet J Rare Dis. 2007;2:24. Published 2007 May 11. doi:10.1186/1750-1172-2-24
van Lennep M, Singendonk MMJ, Dall'Oglio L, et al. Oesophageal atresia [published correction appears in Nat Rev Dis Primers. 2024 Mar 22;10(1):24]. Nat Rev Dis Primers. 2019;5(1):26. Published 2019 Apr 18. doi:10.1038/s41572-019-0077-0
McCann ME, Soriano SG. Progress in anesthesia and management of the newborn surgical patient. Semin Pediatr Surg. 2014;23(5):244-248. doi:10.1053/j.sempedsurg.2014.09.003
Subramaniam R. Anaesthetic concerns in preterm and term neonates. Indian J Anaesth. 2019;63(9):771-779. doi:10.4103/ija.IJA_591_19
