Esophageal @entity254 medial to preserved azygos vein in XXXX with @entity4501 : restoration of normal mediastinal anatomy.

@entity1 @entity10859 @entity154 @entity295 @entity834 @entity4501 @entity1152 @entity55 @entity254 @entity20434 @entity260 @entity86
OBJECTIVE: We intended to prospectively study the technical feasibility and advantages of esophageal @entity254 medial to the preserved azygos vein in neonates diagnosed with @entity1152 with @entity4501 (EA/ @entity10859 ). The results were compared to the cases where azygos vein was either not preserved, or the @entity254 was done lateral to the arch of preserved azygos vein. MATERIAL AND METHODS: A total of 134 @entity1 with EA/ @entity10859 were admitted between January 2007 and July 2008 of which 116 underwent primary repair. Eleven @entity1 with long gap @entity20434 and 7 @entity1 who expired before surgery were excluded. @entity1 were randomly divided in three groups comparable with respect to the gestational age, age at presentation, sex, birth weight, associated anomalies and the gap between the pouches after mobilization: Group A (azygos vein ligated and divided), Group B (azygos vein preserved with esophageal @entity254 lateral to the vein), and Group C azygos vein preserved with esophageal @entity254 medial to the vein). All the @entity1 were operated by extra-pleural approach. The three groups were compared with respect to operative time and early @entity260 like @entity55 , @entity834 and mortality. Odds ratio and Chi square test were used for the statistical analysis. RESULTS: Group A, B and C had 35, 43 and 38 @entity1 respectively. No significant difference was observed in average operative time in the 3 groups. Though incidence of @entity86 was higher in group A (28%) as compared to group B (13.95%) and group C (11.62%), it was not statistically significant (p > 0.005). @entity834 occurred in 7 @entity1 in group A (20%), 6 @entity1 in group B (13.95%) and 4 @entity1 (10.52%) in group C (p > 0.005). Group A had 3 major and 4 minor @entity834 ; group B had 2 major and 4 minor leaks and group C had 1 major and 3 minor leaks. There were10 deaths in the series- 5 in group A, 3 in group B and 2 in group C (p > 0.005). @entity1 with major @entity834 in all 3 groups expired after re-exploration. The minor leaks were managed conservatively and all of them healed spontaneously. Severe @entity55 and @entity295 in @entity1 having @entity154 also contributed to the mortality. CONCLUSIONS: Although esophageal @entity254 medial to the preserved azygos vein restores the normal mediastinal anatomy without technical difficulty or increased operative time, the study could not prove a statistically significant advantage in terms of mortality and @entity260 .
