Long-gap esophageal atresia

Shieh, Hester F.; Jennings, Russell W.

doi:10.1053/j.sempedsurg.2017.02.009

Cited by 61 publications

(42 citation statements)

References 78 publications

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“…The management of long-gap esophageal atresia remains challenging with limited evidence and consensus on the definition, evaluation, and surgical approach. [2][3][4]9,[26][27][28] The variety of management strategies that have been employed testify to the challenge it presents. 8 In 2017, the International Network of Esophageal Atresia (INoEA) presented a position paper on the definition of longgap esophageal atresia and the best diagnostic and treatment strategies also highlighting the necessity of experience and communication in the management of these challenging patients.…”

Section: Discussionmentioning

confidence: 99%

“…2,4,8,26,[40][41][42] No randomized controlled trials comparing different approaches of surgical repair or comparing the various techniques used to manage long-gap esophageal atresia are available. 8 Fundamentally, it must be Follow-up Application of indwelling balloon dilatation, endoscopic knife, and surgical resection and reanastomosis in cases of recurrent anastomotic stricture stated that preservation of the native esophagus should be aimed before considering any replacement technique 9,28,43 as "no other conduit can replace its function in transporting food from the oral cavity to the stomach satisfactorily". 44 In this light, it is interesting to mention that thoracoscopic pouch mobilization and placement of traction sutures are considered a novel technique that shows promise, but should only be performed in specialized centers with prospective review and reporting of outcomes (►Table 3, f).…”

Section: Esophageal Reconstructionmentioning

confidence: 99%

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ERNICA Consensus Conference on the Management of Patients with Long-Gap Esophageal Atresia: Perioperative, Surgical, and Long-Term Management

et al. 2020

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Introduction Evidence supporting best practice for long-gap esophageal atresia is limited. The European Reference Network for Rare Inherited Congenital Anomalies (ERNICA) organized a consensus conference on the management of patients with long-gap esophageal atresia based on expert opinion referring to the latest literature aiming to provide clear and uniform statements in this respect. Materials and Methods Twenty-four ERNICA representatives from nine European countries participated. The conference was prepared by item generation, item prioritization by online survey, formulation of a final list containing items on perioperative, surgical, and long-term management, and literature review. The 2-day conference was held in Berlin in November 2019. Anonymous voting was conducted via an internet-based system using a 1 to 9 scale. Consensus was defined as ≥75% of those voting scoring 6 to 9. Results Ninety-seven items were generated. Complete consensus (100%) was achieved on 56 items (58%), e.g., avoidance of a cervical esophagostomy, promotion of sham feeding, details of delayed anastomosis, thoracoscopic pouch mobilization and placement of traction sutures as novel technique, replacement techniques, and follow-up. Consensus ≥75% was achieved on 90 items (93%), e.g., definition of long gap, routine pyloroplasty in gastric transposition, and avoidance of preoperative bougienage to enable delayed anastomosis. Nineteen items (20%), e.g., methods of gap measurement were discussed controversially (range 1–9). Conclusion This is the first consensus conference on the perioperative, surgical, and long-term management of patients with long-gap esophageal atresia. Substantial statements regarding esophageal reconstruction or replacement and follow-up were formulated which may contribute to improve patient care.

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Section: Discussionmentioning

confidence: 99%

Section: Esophageal Reconstructionmentioning

confidence: 99%

ERNICA Consensus Conference on the Management of Patients with Long-Gap Esophageal Atresia: Perioperative, Surgical, and Long-Term Management

et al. 2020

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“…Gastric transposition is currently the most common technique for esophageal replacement, likely due to its technical ease, single anastomosis, and robust vascular supply. 36 Spitz described gastric transposition in four infants with pure EA in 1984. 37 Since, Spitz published a series of 173 children who underwent gastric transposition, majority for EA.…”

Section: Stomachmentioning

confidence: 99%

“…40,41 It is less popular due to the need for a large suture line and with an increased leak and stricture rate. 36…”

Section: Stomachmentioning

confidence: 99%

“…Jejunal and ileal interposition grafts are the most technically difficult procedures but may have the best long-term functional outcomes. 36 Ring et al described a series of staged jejunal interpositions performed in 32 children in 1982. 44 There were no reported failures of the graft to reach the proximal pouch, no graft loss, and no mortalities.…”

Section: Small Bowelmentioning

confidence: 99%

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Esophageal Atresia: State of the Art in Translating Experimental Research to the Bedside

2019

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Impact of definitive surgery for esophageal atresia on long‐term outcomes in patients with trisomy 18

Tamaki,

Iwatani,

Ikuta

et al. 2024

American J of Med Genetics Pt A

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This study investigates the long‐term outcomes of palliative and definitive surgeries for esophageal atresia (EA) in patients with trisomy 18 syndrome. A retrospective study included 25 cases undergoing EA surgery at our center between 2008 and 2022. The Palliative group (n = 16) comprised 13 cases with esophageal banding and 3 with tracheoesophageal fistula (TEF) division. The Definitive group (n = 9) included 5 cases with primary repair and 4 with staged repair following TEF division. The patient characteristics exhibited no significant differences between the groups. In the Definitive group, 56% (5/9) were successfully weaned off mechanical ventilation, compared with none in the Palliative group (p = 0.002). Survival‐to‐discharge rates were 31% (5/16) in the Palliative group and 67% (6/9) in the Definitive group. Home ventilator management was required for all 5 cases that required ventilation in the Palliative group, whereas only 17% (1/6) in the Definitive group needed it. The Palliative group also required continuous oral suction for persistent saliva removal, with two cases undergoing laryngotracheal separation. Overall, definitive surgery for EA in patients with trisomy 18 syndrome may provide enhanced respiratory stability, thereby improving the survival‐to‐discharge rate and overall quality of life for patients and their families.

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Long-gap esophageal atresia

Cited by 61 publications

References 78 publications

ERNICA Consensus Conference on the Management of Patients with Long-Gap Esophageal Atresia: Perioperative, Surgical, and Long-Term Management

ERNICA Consensus Conference on the Management of Patients with Long-Gap Esophageal Atresia: Perioperative, Surgical, and Long-Term Management

Esophageal Atresia: State of the Art in Translating Experimental Research to the Bedside

Impact of definitive surgery for esophageal atresia on long‐term outcomes in patients with trisomy 18

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