[Two cases of gross E-type tracheo-esophageal fistulae associated with interruption of the aortic arch and coarctation of the aorta in early infancy].

Two cases of Gross E-type tracheoesophageal fistulae associated with interruption of the aortic arch in one and coarctation of the aorta in the other in early infancy were treated radically at Nagano Children's Hospital during the preceding 4 months until January 1994. The tracheoesophageal fistulae were noticed after the first stage surgery for the aortic arch anomalies, because of the remarkable abdominal distension under the intubated and ventilated condition of general anesthesia. Both the bronchial and esophageal optical fiber examinations were performed which proved useful to detect the fistulae. In each case, the transcervical division of the fistula was performed on an emergency basis. The external diameter of the fistula was 4 and 5 mm respectively. The fistulae dilated synchronously with ventilation. The early detection and surgical correction of the tracheoesophageal fistula can prevent serious complications such as DIC as seen in the first case probably caused by respiratory infection associated with the prolonged mechanical ventilation. Successful intracardiac repair were performed in both cases on the 25th and 7th day following the correction of the fistulae respectively.

Partial liver transplantation from living related donors.

Living related liver transplantation was performed in five cases between June 1989 and July 1991 at Shinshu University Hospital. All of the donors were fathers of the patients and blood type was identical in each case. All of them were discharged from the hospital 2 weeks after hepatectomy without any complications. They started to work 2 months after surgery. Four recipients are surviving but one died. Three are enjoying daily life 17 months after LT in case 1, 5 months after LT in case 4, and 4 months after LT in case 5. Case 2 is still in the hospital 14 months after LT. Advantages of LRLT we noted were (1) cases can be performed totally electively and allow full preparation for the family and the transplant team, (2) primary graft nonfunction has not been observed to date, and (3) 38 patients received the chance of liver transplantation in their own country, which under current legislation would not otherwise have been possible. Disadvantages of LRLT were (1) partial hepatectomy was performed in healthy persons, and (2) retransplantation is difficult.