Shanghai doctors save HK boy with rare congenital defect

Cai Wenjun
A congenital defect meant the 1-year-old couldn't feed properly and risked suffocation. Surgeons said any mistakes could prove fatal but the challenging operation was a success.
Cai Wenjun

A 1-year-old boy with a rare congenital defect can now eat normally thanks to successful surgery at the Children's Hospital of Fudan University, the hospital said on Tuesday.

Previously, he had to be fed through a tube as a gap in the tissues between his larynx and esophagus meant food and liquids could enter the trachea and lungs, causing choking and respiratory problems. There was also a risk of suffocation.

Shanghai doctors save HK boy with rare congenital defect
Ti Gong

The boy is fed normally thanks to successful surgery.

Laryngeal clefts affect just one in every 10,000 or 20,000 births.

There are four types depending on size and location and the boy had type III, the second most serious.

Minimally invasive surgery in Hong Kong had failed to solve the issue and doctors there had recommended he be taken to the UK for treatment.

His mother said she had heard that the Shanghai hospital had experience in treating such patients.

"So we contacted doctors for consultation and then we chose this hospital because of its previous success and its near distance," she said. She brought her son to Shanghai on October 16.

The hospital's Dr Chen Chao said: "There is no chance for any mistake. Since the boy has received one surgery, the second one would be more risky and challenging. If we failed, he could face death or depend on a feeding pipe for living in his entire life.

"To ensure success, we conducted profound checks and preparations to decide to adopt an open surgery by transplanting part of the patient's own rib cartilage to cover the gap as well as detailed management plans before, during and after surgery."

The 4-hour operation on October 18 went well. After three weeks of monitoring and rehabilitation in the ICU, the little boy was transferred to a normal ward for further recovery and feeding training.

Shanghai doctors save HK boy with rare congenital defect
Ti Gong

Doctors from the Children's Hospital of Fudan University pictured during the laryngeal cleft surgery.

"It is the first time that we can feed him by spoon. It is such a great thing," the mother said.

The boy has since been discharged.

Surgery for serious laryngeal clefts is complicated. A limited number of hospitals in Europe and the US can carry out surgery on type IV. In Asia, only leading hospitals in Japan and Fudan's children's hospital have reported successful treatment on patients with the type IV defect. Local experts had studied the technology at Cincinnati Children's Hospital.

"Our patients are from over all the country as well as overseas," Chen said. "Our medical capability and reported success rate is the same as hospitals in the US and Europe now. But the medical cost is much lower."

Treatment for congenital defects is one of the strongest features of the hospital, which is also part of the National Children's Medical Center.

In a recent case, the hospital conducted surgery on a newborn girl with diaphragmatic hernia, an opening in the diaphragm causing her abdominal organs to push into her chest cavity.

The girl, whose parents are from China and Finland, was born on October 4 but immediately transferred to the hospital after having difficulty in breathing.

On October 6, an operation to repair the hole using a robotic surgical system was a success.

The baby has since been discharged.

Shanghai doctors save HK boy with rare congenital defect
Ti Gong

A doctor operates a robotic surgical system at the Fudan hospital.


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