A simple and safe method to visualize the inferior pouch in esophageal atresia without fistula

Abstract

The authors studied the true "dynamic" distance between the esophageal stumps in type I atresia in order to perform the delayed anastomosis at the most favorable time. The position of the inferior pouch was fluoroscopically evaluated in four patients, inserting a Hegar dilator through the gastrostomy. The superior esophageal pouch was delineated by a Replogle tube. No anesthesia was required. In all cases the procedure was simple, safe, fast, and accurate. No complications occurred, and patients could be operated upon at the optimal time.

Radiographic assessment of the gap between oesophageal pouches in infants with oesophageal atresia without fistula

“…As stated by Rossi et al [2], we also find this method ''simple, fast, safe and accurate'' and in good correlation with the surgical findings. In addition, this method simulates the tension that will often be applied on both pouches while performing the anasthomosis, and assists in predicting the extent of tissue dissection that will be necessary.…”

“…Another simple method for the assessment of the gap between the oesophageal pouches has been reported, as also quoted by the authors of the above-mentioned article [2]. Over the last 3 years, we have been using this method for the evaluation of eight infants awaiting surgical repair for oesophageal atresia without fistula.…”

“…Over the last 3 years, we have been using this method for the evaluation of eight infants awaiting surgical repair for oesophageal atresia without fistula. In a similar fashion to the method described by Rossi et al [2], a 20F mercury filled oesophageal dilator is inserted orally into the proximal pouch. An endotracheal tube (No.…”

Evaluation of oesophageal atresia without fistula by three-dimensional computed tomography

“…For a delayed primary anastomosis, an accurate assessment of the distance between the two blind ends of the oesophagus is highly desirable. Some methods have been reported for measuring the gap between the oesophageal pouches [1,4,5]; however, they either need injection of contrast medium via the gastrostomy, or an invasive insertion of endoscopes through the cardia. Our new method of 3DCT can be performed easily and non-invasively with air contrast in both proximal and distal oesophageal segments.…”

Reply

“…Some methods had been reported for measuring the gap between the oesophageal pouches [1, 2, 3]. The method which was mentioned seems simple, fast and accurate but not new, and was modified from Rossi et al [2]. For practical purposes, this method is not our decided preference because contrast medium has to be injected through the gastrostomy.…”