ABSTRACT
OBJECTIVE@#To summarize the experience in the application of muscle relaxants in the perioperative period in neonates with congenital esophageal atresia-tracheoesophageal fistula (EA-TEF).@*METHODS@#A retrospective analysis was performed on the medical data of 58 previously untreated neonates with EA-TEF who were treated in the Neonatal Center of Beijing Children's Hospital, Capital Medical University from 2017 to 2019. The incidence rate of anastomotic leak was compared between the neonates receiving muscle relaxants for different durations after surgery (≤ 5 days and > 5 days). The correlation between the duration of postoperative use of muscle relaxants and the duration of mechanical ventilation was evaluated.@*RESULTS@#Among the 58 neonates with EA-TEF, 44 underwent surgery, among whom 35 with type III EA-TEF underwent thoracoscopic surgery. Among these 35 neonates, 30 (86%) received muscle relaxants after surgery, with a median duration of 4.75 days, and 6 (18%) experienced anastomotic leak. There was no significant difference in the incidence rate of anastomosis leak between the ≤ 5 days and > 5 days groups (@*CONCLUSIONS@#Prolonged use of muscle relaxants after surgery cannot significantly reduce the incidence of anastomotic leak, but can prolong the duration of invasive mechanical ventilation in neonates with EA-TEF. Therefore, prolonged use of muscle relaxants is not recommended after surgery.
Subject(s)
Child , Humans , Infant, Newborn , Esophageal Atresia/surgery , Muscles , Postoperative Complications/etiology , Prognosis , Retrospective Studies , Tracheoesophageal Fistula/surgery , Treatment OutcomeABSTRACT
The stomachs of the yellow-billed grosbeaks were examined by means of light microscopy. The mucous membrane of the proventriculus presented many folds and sulci. The sulci were lined by simple columnar cells with basal nuclei and clear acidophilic cytoplasm. The proventriculus glands were constituted by many round or elliptical glandular lobules. The sulci and the collecting duct of compound tubular glands showed an intense positive reaction in PAS and AB stain. The gizzard was characterized by an internal abrasion-resistant lining cuticle and a thick muscular layer. The cuticle, gizzard glands and muscular layer in two sides were thicker than those in the cranial and caudal.
Los estómagos del Pepitero de cola negra fueron examinados mediante microscopía óptica. La membrana mucosa del proventrículo presentó muchos pliegues y surcos. Los surcos estaban revestidos por células columnares simples con núcleos basales y un citoplasma claro acidófilo. Las glándulas proventriculares estaban constituidos por abundantes lóbulos glandulares redondos o elípticos. Los surcos y conductos colectores de las glándulas tubulares compuestas mostraron una reacción positiva e intensa a las tinciones de PAS y AB. La molleja estomacal se caracterizó por una cutícula de revestimiento resistente a la abrasión interna y una capa muscular gruesa. La cutícula, glándulas de la molleja y capa muscular en ambos lados eran más gruesas que en la craneal y caudal.