Anastomotic technic in esophageal atresia

Cloud, Daniel T.

doi:10.1016/0022-3468(68)90106-1

Cited by 23 publications

(4 citation statements)

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“…No other operation offers a greater opportunity for pure technical artistry." 19 This statement made by Dr. Willis J. Potts in the 1950s has lost none of its relevance. 19 In addition to surgery and refinement of surgical technique, newly developed drugs and equipment and continuous optimization of treatment strategies has led to constantly improved survival rates of neonates born with EA over time.…”

Section: Discussionmentioning

confidence: 99%

“…19 This statement made by Dr. Willis J. Potts in the 1950s has lost none of its relevance. 19 In addition to surgery and refinement of surgical technique, newly developed drugs and equipment and continuous optimization of treatment strategies has led to constantly improved survival rates of neonates born with EA over time. Before the era of surgical correction, the diagnosis of EA was a death sentence, but overall mortality reached a single-digit rate in the last decade.…”

Section: Discussionmentioning

confidence: 99%

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State of Play: Eight Decades of Surgery for Esophageal Atresia

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

State of Play: Eight Decades of Surgery for Esophageal Atresia

et al. 2018

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“…[10] reported a survival rate of 57.6% in 113 infants treated in the early 1950's. Willis Potts [11] in 1950 wrote "To anastomose the ends of an infant's oesophagus, the surgeon must be as delicate and precise as a skilled watchmaker. No other operation offers a greater opportunity for pure technical artistry".…”

Section: Historymentioning

confidence: 99%

Oesophageal atresia

Spitz

2007

Orphanet J Rare Dis

413

352

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Oesophageal atresia (OA) encompasses a group of congenital anomalies comprising of an interruption of the continuity of the oesophagus with or without a persistent communication with the trachea. In 86% of cases there is a distal tracheooesophageal fistula, in 7% there is no fistulous connection, while in 4% there is a tracheooesophageal fistula without atresia. OA occurs in 1 in 2500 live births. Infants with OA are unable to swallow saliva and are noted to have excessive salivation requiring repeated suctioning. Associated anomalies occur in 50% of cases, the majority involving one or more of the VACTERL association (vertebral, anorectal, cardiac, tracheooesophageal, renal and limb defects). The aetiology is largely unknown and is likely to be multifactorial, however, various clues have been uncovered in animal experiments particularly defects in the expression of the gene Sonic hedgehog (Shh). The vast majority of cases are sporadic and the recurrence risk for siblings is 1%. The diagnosis may be suspected prenatally by a small or absent stomach bubble on antenatal ultrasound scan at around 18 weeks gestation. The likelihood of an atresia is increased by the presence of polyhydramnios. A nasogastric tube should be passed at birth in all infants born to a mother with polyhydramnios as well as to infants who are excessively mucusy soon after delivery to establish or refute the diagnosis. In OA the tube will not progress beyond 10 cm from the mouth (confirmation is by plain X-ray of the chest and abdomen). Definitive management comprises disconnection of the tracheooesophageal fistula, closure of the tracheal defect and primary anastomosis of the oesophagus. Where there is a "long gap" between the ends of the oesophagus, delayed primary repair should be attempted. Only very rarely will an oesophageal replacement be required. Survival is directly related to birth weight and to the presence of a major cardiac defect. Infants weighing over 1500 g and having no major cardiac problem should have a near 100% survival, while the presence of one of the risk factors reduces survival to 80% and further to 30-50% in the presence of both risk factors.

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“…The incidence of congenital esophageal stenosis was estimated at 1:25,000 to 50,000 live births, and the incidence of other congenital anomalies associated with CES ranges from 17% to 33% [13] . There are 3 pathologic/ histological types of CES that have been described in the literature: (1) Fibro muscular thickening, (2) cartilaginous ring, and (3) membranous web [14,15] .…”

Section: Discussionmentioning

confidence: 99%

Congenital Tracheoesophageal Fistula with or without Esophageal Atresia, King Abdulaziz University Hospital Experience over 15 Years

Rayes¹

2010

med

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The aim is to study the profile of congenital tracheoesophageal fistula with or without esophageal atresia with the effect of modalities of surgical and postoperative management on their outcome. Retrospective study of the records of all cases that had been diagnosed as congenital tracheoesophageal fistula with or without esophageal atresia treated at King Abdulaziz University Hospital, between 1992 and 2007 inclusive were reviewed. A total of 48 neonates were studied. Forty-three cases (72.8%) had esophageal atresia with distal fistula: ten cases were pure esophageal atresia; one case had esophageal atresia with proximal and distal fistulae. Four cases had H-type of tracheoesophageal fistula. On applying the Waterston prognostic classification to all patients, the survival rate was 94.5%, 76.2% and 22.2% for classes A, B and C, respectively. Incidence of esophageal congenital anomalies in KAUH was 1:3574 life births, with male: female ratio 3:2. The overall mortality rate was 25%, whereas the mortality rate among operated cases was 20%. Seven cases developed stricture (15.5%) and 5 had anastomotic leaks (11.1%).

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Anastomotic technic in esophageal atresia

Cited by 23 publications

References 1 publication

State of Play: Eight Decades of Surgery for Esophageal Atresia

State of Play: Eight Decades of Surgery for Esophageal Atresia

Oesophageal atresia

Congenital Tracheoesophageal Fistula with or without Esophageal Atresia, King Abdulaziz University Hospital Experience over 15 Years

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