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  • 11
    Electronic Resource
    Electronic Resource
    Cardiovascular malformations in rat fetuses with oesophageal atresia and tracheo-oesophageal fistula induced by adriamycin (1997)
    Springer
    Pediatric surgery international 12 (1997), S. 556-564 
    Details
    ISSN: 1437-9813
    Keywords: Key words Cardiovascular abnormality ; Oesophageal atresia ; Tracheo-oesophageal fistula ; Adriamycin ; Fetal rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Associated congenital anomalies have emerged as the most significant prognostic factor in babies born with oesophageal atresia and/or tracheo-oesophageal fistula (OA-TOF). The most frequently encountered groups of anomalies are cardiovascular (CV) and gastrointestinal, the former being more significant from a prognostic point of view. Some, such as a right-sided aortic arch (RAA), vascular ring, or major heart defects, may alter the timing and surgical approach for the repair of OA-TOF or adversely affect the prognosis. The rat fetal OA model induced by adriamycin (Adr) has been described previously. In the present experiments, information was sought regarding the incidence and type of CV abnormalities in fetal rats obtained from Adr-treated dams. OA-TOF was induced in 24 of 36 fetal rats from Adr-treated dams. DV abnormalities were found in 18 (75%) OA-TOF fetuses and 10 (83%) Adr-treated fetuses without OA-TOF. The difference was not significant (P 〉0.05). The most frequently found anomalies were ventricular and atrial septal defects. A RAA was present in 8/36 fetuses and a double aortic arch in 2/36. A patent ductus arteriosus was present in all treated fetuses compared with two-thirds of controls. The findings in the present study emphasise the importance of CV anomalies in association with OA, and reinforce the value of the Adr-induced rat fetal OA model by adding to our knowledge of the basic embryogenesis of both OA and CV anomalies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01371899
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  • 12
    Electronic Resource
    Electronic Resource
    Oesophageal atresia in theory and in practice (1999)
    Springer
    Pediatric surgery international 15 (1999), S. 1-1 
    Details
    ISSN: 1437-9813
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050498
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  • 13
    Electronic Resource
    Electronic Resource
    Association of oesophageal atresia and cholecystohepatic duct (1999)
    Springer
    Pediatric surgery international 15 (1999), S. 21-23 
    Details
    ISSN: 1437-9813
    Keywords: Key words Oesophageal atresia ; Extrahepatic abnormalities of biliary tract ; Cholecystohepatic duct
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A rare hepatobiliary malformation in which the common hepatic duct drains directly into the gallbladder or the cystic duct (cholecystohepatic duct) is described in two children born with oesophageal atresia. Attention is drawn to the rarity of this combination. A brief review of the literature of cholecystohepatic and accessory hepatic ducts is also presented.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050503
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  • 14
    Electronic Resource
    Electronic Resource
    Intrinsic innervation of the oesophagus in fetal rats with oesophageal atresia (1999)
    Springer
    Pediatric surgery international 15 (1999), S. 2-7 
    Details
    ISSN: 1437-9813
    Keywords: Key words Oesophageal atresia ; Tracheo-oesophageal fistula ; Fetal rat ; Adriamycin ; Intramural innervation of oesophagus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Although the aetiology of oesophageal dysmotility after repair of oesophageal atresia and tracheo-oesophageal fistula (OA-TOF) remains controversial, oesophageal dysmotility also is present in isolated TOF or OA before surgery, suggesting a congenital cause. Our previous work with a model of OA-TOF in fetal rats demonstrated an abnormality in the course and branching pattern of the vagus nerve. However, little is known about the intramural nervous components of the atretic oesophagus. The intrinsic innervation of the atretic oesophagus was examined by immunohistological staining to see if there is an abnormality that might account for dysmotility. OA-TOF was induced in fetal rats by injecting adriamycin intraperitoneally into pregnant rats. Forty-eight controls, 40 OA-TOF, and 6 treated fetuses without OA-TOF were recovered. Whole-mount preparations of each oesophagus were stained with fluorescent antibodies against neuron-specific enolase (NSE), vasoactive intestinal peptide (VIP), substance P (SP), and calcitonin gene-related peptide (CGRP). Compared with control fetuses, the density of the nerve plexus, ganglia, and number of cell bodies per ganglion immunostained by NSE, VIP, or SP was significantly reduced in OA-TOF fetuses. CGRP-immunoreactive nerve fibres in the oesophageal wall of both control and OA-TOF animals were found to be connected with extrinsic nerve bundles. No plexus-like nerve fibre network was observed. The results of the present study demonstrated significant abnormalities of the intramural nervous components of the oesophagus in OA-TOF fetal rats, involving both the excitatory (SP-labelled) and inhibitory (VIP-labelled) intramural nerves. These abnormalities may underlie the oesophageal dysmotility seen in OA-TOF patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050499
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  • 15
    Electronic Resource
    Electronic Resource
    Gastric perforation in infants with oesophageal atresia and distal tracheo-oesophageal fistula (1999)
    Springer
    Pediatric surgery international 15 (1999), S. 24-27 
    Details
    ISSN: 1437-9813
    Keywords: Key words Oesophageal atresia ; Tracheo-oesophageal fistula ; Prematurity ; Gastric perforation ; Pneumoperitoneum ; Balloon catheter
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Gastric perforation (GP) is a well-recognised complication of oesophageal atresia (OA) with distal tracheo-oesophageal fistula (TOF), and is usually associated with extreme prematurity, hyaline membrane disease, and the requirement for assisted ventilation. The presentation is sudden, and leads to further deterioration in respiratory function because of increasing abdominal distension from pneumoperitoneum and splinting of the diaphragm. Unrelieved, the infant becomes increasingly hypoxic and may die. A review of six infants with OA and distal TOF in whom GP occurred has enabled us to develop the following guidelines for the appropriate initial surgical management of this complication: (1) Needle paracentesis of the abdomen en route to surgery if the infant continues to deteriorate; (2) Urgent laparotomy to decompress the abdomen and to occlude the lower oesophagus with a catheter introduced through the GP; (3) Thoracotomy and division of the fistula; (4) Oesophageal anastomosis if the infant's condition improves sufficiently and the anatomy is favourable; and (5) Repair of the GP and formation of a gastrostomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050504
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  • 16
    Electronic Resource
    Electronic Resource
    The frequency, significance, and management of a right aortic arch in association with esophageal atresia (1999)
    Springer
    Pediatric surgery international 15 (1999), S. 28-31 
    Details
    ISSN: 1437-9813
    Keywords: Key words Oesophageal atresia ; Aortic arch ; Tracheo-oesophageal fistula ; Congenital heart disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An unrecognised right aortic arch (RAA) found at thoracotomy may complicate the repair of oesophageal atresia (OA) and tracheo-oesophageal fistula (TOF). This paper analyses the patient characteristics, peri-operative management, and outcome of 16 infants with a RAA, and proposes management guidelines. Between 1948 and 1996, 709 patients with OA/TOF were admitted to the Royal Children's Hospital, of whom 13 had a RAA. Three additional cases from two other paediatric surgical units were included. All 16 case records were reviewed retrospectively. The overall incidence of RAA in OA was 1.8%. Neither a chest radiograph in 16, nor antenatal ultrasonography in 7 detected a RAA. Post-natal echocardiography (ECHG) detected a RAA in only 1 of 7 infants examined; that patient underwent repair of the OA through a left (L) thoracotomy. The other 15 infants underwent initial right (R) thoracotomy. Six of these had a complete repair from the R side and 5 had division of the fistula only; 2 of these 5 had initial division of the fistula, and the OA was repaired through a repeat R thoracotomy 4 and 7 weeks later. In the remaining 4 infants where the fistula could not be located at the initial R thoracotomy, complete repair proved possible through the L chest. Three of these infants underwent an immediate L thoracotomy; the 4th had a delayed L thoracotomy 1 week later. There were 6 deaths: these occurred early in the study and were related to severe prematurity, congenital heart disease (CHD), and post-operative respiratory complications. CHD was identified in 11 of 16 infants (71%). Routine pre-operative ECHG is unreliable in determining the laterality of the aortic arch. Should a RAA be encountered during a R thoracotomy for OA, it is often possible to divide the fistula and repair the OA from that side, but where repair looks potentially difficult it is wise to proceed to an immediate L thoracotomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050505
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  • 17
    Electronic Resource
    Electronic Resource
    Oesophageal atresia without fistula — anastomosis or replacement? (1987)
    Springer
    Pediatric surgery international 2 (1987), S. 216-222 
    Details
    ISSN: 1437-9813
    Keywords: Oesophageal atresia ; Gasless abdomen ; Oesophageal replacement ; Long gap
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract At the Royal Children's Hospital, Melbourne, 553 babies with oesophageal atresia and/or tracheo-eesophageal fistula have been admitted during the past 39 years; 36 (6.5%) of these had oesophageal atresia without a tracheo-oesophageal fistula. Definitive surgery was performed in 27 patients: the primary definitive procedure was oesphageal anastomosis in 15 and oesophageal replacement in 12. Aspects of diagnosis and selection of the most appropriate treatment modality are discussed, with the results of treatment presented. Our current policy is to perform an oesphhageal anastomosis whenever possible, and this has been successful in 7 of the last 11 patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00179574
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  • 18
    Electronic Resource
    Electronic Resource
    Oesophageal atresia and vertebral anomalies (1987)
    Springer
    Pediatric surgery international 2 (1987), S. 278-281 
    Details
    ISSN: 1437-9813
    Keywords: Oesophageal atresia ; Tracheo-oesophageal fistula ; Vertebra ; Spinal anomalies ; Rib
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Oesphageal atresia and/or tracheo-oesophageal fistula are relatively common congenital anomalies, occurring once in 3, 000 births [6, 10]. Associated anomalies are seen frequently, and in a series of 538 patients admitted to the Royal Children's Hospital, Melbourne, 256 had additional anomalies (47.5%). Evaluation of the spine was possible in 345 patients; in 57, structural vertebral anomalies were present (16.5%). Of the 57 with a structural abnormality of the spine, 40 had an abnormality of formation, 6 an abnormality of segmentation, and 10 had a combined defect. In the other patient, a bipartite cervical vertebra was present. Eight patients had scoliosis without a recognisable congenital spinal abnormality. In 81 there was a congenital rib abnormality; 56 of this group had a normal spine, 24 had a structural abnormality of the spine, and in 1 patient scoliosis was present without a structural abnormality of the spine. Comparison is made between our findings and the findings in other reported series and comments are made on the significance of spinal and/or rib anomalies in association with oesophageal atresia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00176198
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  • 19
    Electronic Resource
    Electronic Resource
    Neonatology: recent advances and a plea for rational therapy (1994)
    Springer
    Pediatric surgery international 9 (1994), S. 465-466 
    Details
    ISSN: 1437-9813
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00179441
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  • 20
    Electronic Resource
    Electronic Resource
    Vesical exstrophy (1995)
    Springer
    Pediatric surgery international 10 (1995), S. 287-288 
    Details
    ISSN: 1437-9813
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00182205
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