Conservative management of major anastomotic leaks occurring after primary repair in esophageal atresia with fistula: Role of extrapleural approach

Kulshrestha, Sanjay; Kulshrestha, Meeta; Tewari, Vinay; Chaturvedi, N.; Goyal, Atul Kumar; Sharma, Ram Kshitij; Sarkar, Debashish; Tandon, Jeetendra Narayan; Katyal, Vijay

doi:10.4103/jiaps.jiaps_73_19

Cited by 4 publications

(2 citation statements)

References 29 publications

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“…The complications that followed this surgery are common, occurring in 15-20% of the patients [3]. Leaks are either minor or major, minor leaks are managed conservatively with drainage, prolonged fasting and TPN, and broad-spectrum antibiotics until the leak seals by itself [12,13]. Some studies compared conservative management with early surgical interventions to close the defect, but no significant difference has been detected [14].…”

Section: Discussionmentioning

confidence: 99%

Isolated distal esophageal atresia in neonates: a case report and review of the literature

et al. 2022

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Esophageal atresia occurs in 1 out of 2500 to 4500 live births; an isolated variant occurs in 8% of the cases. In this case report and literature review, we present a rare case of isolated distal esophageal atresia happening just 2 cm above the diaphragmatic right leaflet with the connecting band between the two esophageal parts. The location raised the possibility of a direct vascular accident to that segment as a cause of the atresia. Post-operative ambu bagging may facilitate leak at the anastomosis site and should be done carefully, as well as, to introduce contrast with suckling not with jet injection for the same reason. We mentioned that to raise a wariness as this mishap may cause problems.

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Section: Discussionmentioning

confidence: 99%

Isolated distal esophageal atresia in neonates: a case report and review of the literature

et al. 2022

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“…First, the database records OPS procedure codes but not diagnoses. Second, some of the anastomoses recorded in the first year of life actually may have been performed on the same patient as redo procedures, although recent data 9 15 suggest that these cases are rare and perhaps negligible for our purpose.…”

Section: Limitationsmentioning

confidence: 99%

Esophageal Interventions in Infants Born with Esophageal Atresia: A Comprehensive Analysis of a National Database

et al. 2021

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Introduction Esophageal atresia (EA) is a rare malformation that often requires a series of procedures, including surgical primary anastomosis, staged repair, and endoscopic procedures. Actual numbers and trends in interventions and variety in treatment strategies remain unclear. Materials and Methods Data from the German federal bureau of statistics containing all EA-related inpatient procedures encoded from 2005 until 2018 were analyzed for children during the first year of life. The sum of esophageal anastomoses and replacements was used to calculate an estimate of incidence of EA. Results Over 14 years, 12,627,888 inpatient cases were recorded in infants in Germany. The mean incidence of EA was 1 per 4,217 live births. On average, 163.3 (95% confidence interval [CI]: 150.8–176.1) esophageal anastomoses, 11.2 (95% CI: 8.7–13.7) esophageal lengthening procedures, and 6.7 (95% CI: 5.42–8.00) esophageal replacements were recorded annually. Overall, 187.8 (95% CI: 147.1–200.4) endoluminal treatments (ballon dilatation, bougienage, stent placement, or injection) were performed per 100 anastomoses. Over the years, bougienage was increasingly replaced by ballon dilatation as primary treatment. Boys had a significantly higher number of esophageal procedures than girls, but the incidence of endoscopic treatments in relation to anastomoses was the same for both genders. Conclusion The low incidence of EA in relation to a relatively large number of units treating those patients in Germany may pose challenges for maintaining competency and training of all specialists involved. The number of esophagoscopic treatments for esophageal stricture per anastomosis is lower than previously estimated.

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Association of type I choledochal cyst, type III esophageal atresia, evanescent testicle, and clinodactyly: A case report

Escárcega-Fujigaki¹,

Hernández-Peredo-Rezk²,

Velez-Blanco³

et al. 2023

Journal of Pediatric Surgery Case Reports

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Conservative management of major anastomotic leaks occurring after primary repair in esophageal atresia with fistula: Role of extrapleural approach

Cited by 4 publications

References 29 publications

Isolated distal esophageal atresia in neonates: a case report and review of the literature

Isolated distal esophageal atresia in neonates: a case report and review of the literature

Esophageal Interventions in Infants Born with Esophageal Atresia: A Comprehensive Analysis of a National Database

Association of type I choledochal cyst, type III esophageal atresia, evanescent testicle, and clinodactyly: A case report

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