Oesophageal atresia and tracheo-oesophageal fistula

Smith, Nicola

doi:10.1016/j.earlhumdev.2014.09.012

Cited by 42 publications

(42 citation statements)

References 10 publications

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“…The most used definition of long gap OA is a gap greater than two to four vertebral bodies or 4–6 cm in length, although others have defined it as the inability of joining the esophagus at the first surgery with the result that there has been no unanimous definition for the two groups (4). In the current issue, the International Network of Esophageal Atresia has proposed that any OA that has no intra-abdominal air should be considered as long-gap (see the article by Van Der Zee et al).…”

Section: Introductionmentioning

confidence: 99%

Update on Foregut Molecular Embryology and Role of Regenerative Medicine Therapies

et al. 2017

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Esophageal atresia (OA) represents one of the commonest and most severe developmental disorders of the foregut, the most proximal segment of the gastrointestinal (GI) tract (esophagus and stomach) in embryological terms. Of intrigue is the common origin from this foregut of two very diverse functional entities, the digestive and respiratory systems. OA appears to result from incomplete separation of the ventral and dorsal parts of the foregut during development, resulting in disruption of esophageal anatomy and frequent association with tracheo-oesophageal fistula. Not surprisingly, and likely inherent to OA, are associated abnormalities in components of the enteric neuromusculature and ultimately loss of esophageal functional integrity. An appreciation of such developmental processes and associated defects has not only enhanced our understanding of the etiopathogenesis underlying such devastating defects but also highlighted the potential of novel corrective therapies. There has been considerable progress in the identification and propagation of neural crest stem cells from the GI tract itself or derived from pluripotent cells. Such cells have been successfully transplanted into models of enteric neuropathy confirming their ability to functionally integrate and replenish missing or defective enteric nerves. Combinatorial approaches in tissue engineering hold significant promise for the generation of organ-specific scaffolds such as the esophagus with current initiatives directed toward their cellularization to facilitate optimal function. This chapter outlines the most current understanding of the molecular embryology underlying foregut development and OA, and also explores the promise of regenerative medicine.

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Section: Introductionmentioning

confidence: 99%

Update on Foregut Molecular Embryology and Role of Regenerative Medicine Therapies

et al. 2017

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“…Predomina en el sexo masculino y la raza blanca, con factores de riesgo: primigestantes, edad materna avanzada y embarazo gemelar. 13,14 En el 50% de los casos, existen malformaciones congénitas asociadas; las gastrointestinales se presentan en el 25%; y la asociación VACTER (anormalidades vertebrales, anales, cardíacas, traqueales, esofágicas y renales) ocurre en el 10-20%. 14,15 Se han reportado más de cien tipos de AE; la más frecuente es la AE con FTE inferior.…”

Section: Atresia De Esófagounclassified

“…El perfeccionamiento de técnicas quirúrgicas junto con los avances en cuidados neonatales ha mejorado el pronóstico de los pacientes y, en la actualidad, la supervivencia depende más de la presencia o ausencia de otras malformaciones que de la AE-FTE en sí. 13,15 Existen complicaciones posoperatorias tempranas, como dehiscencia de sutura, estenosis esofágica y refístula, y complicaciones alejadas, que pueden ser digestivas (reflujo gastroesofágico, estenosis, dismotilidad) y respiratorias. La ERGE es una de las complicaciones gastrointestinales más frecuentes y ocurre hasta un 58%.…”

Section: Atresia De Esófagounclassified

Esofagitis eosinofílica y atresia esofágica: ¿casualidad o causalidad?

Salgado¹,

Rocca²

2018

Arch Argent Pediatr

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RESUMENLa esofagitis eosinofílica es una enfermedad crónica del esófago, inmunomediada, caracterizada por síntomas de disfunción esofágica y eosinofilia tisular. Endoscópicamente, la mucosa esofágica puede ser normal o tener exudados, anillos, edema, surcos y estenosis. El tratamiento se basa en dieta de exclusión, corticoterapia tópica y/o dilatación esofágica. La atresia es la alteración congénita más frecuente del esófago, requiere corrección quirúrgica con posibles complicaciones, como reflujo gastroesofágico, estenosis y dismotilidad esofágica. Hasta el año 2015, fueron comunicados 48 casos de esofagitis eosinofílica en atresia esofágica, en los que tuvo participación la dismotilidad, el reflujo y la supresión ácida prolongada. Clínicamente, predominan la disfagia, las dificultades en la alimentación y los síntomas de reflujo, por tanto, se sugiere la endoscopía digestiva alta con biopsias para descartar esofagitis eosinofílica asociada en pacientes con atresia esofágica y síntomas persistentes antes de realizar dilatación esofágica y/o cirugía antirreflujo. Si se confirma esofagitis eosinofílica, debe tratarse con medicación apropiada y subsiguientes conductas terapéuticas dependerán de su evolución. Palabras clave: esofagitis eosinofílica, atresia esofágica, disfagia.

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“…It is more predominant among males and Caucasians, and in case of the following risk factors: primigravida women, advanced maternal age, and twin pregnancy. 13,14 Also, 50% of cases have associated congenital malformations; gastrointestinal malformations occur in 25%; and the VACTER sequence (vertebral, anorectal, cardiac, tracheo-esophageal, and renal defects) has been observed in 10-20%. 14 14 EA is commonly diagnosed in the first 24 hours of life, although it can be suspected antenatally due t o the presence of polihydramnios, a prominent esophageal pouch or a small or absent stomach during the third trimester of gestation.…”

Section: Esophageal Atresiamentioning

confidence: 99%

“…Improvements in surgical techniques together with advances in neonatal care have enhanced patient prognosis and, at present, survival is more dependent on the presence or absence of other malformations than on EA-TEF itself. 13,15 Early post-operative complications may occur, including wound dehiscence, esophageal stricture and refistula, and late complications, which may affect the gastrointestinal (gastroesophageal reflux, stricture, dysmotility) and respiratory systems. GERD is one of the most common gastrointestinal complications, occurring in up to 58% of patients.…”

Section: Esophageal Atresiamentioning

confidence: 99%

Eosinophilic esophagitis and esophageal atresia: coincidence or causality?

Salgado

Rocca

2018

Arch Argent Pediatr

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Eosinophilic esophagitis is an immune-mediated chronic disease of the esophagus characterized by symptoms related to esophageal dysfunction and tissue eosinophilia. In the endoscopy, the esophageal mucosa may appear normal or show exudates, rings, edema, furrows, and strictures. Its management is based on elimination diet, topical corticosteroids and/or esophageal dilation. Atresia is the most common congenital alteration of the esophagus; it requires surgical repair and poses potential complications, such as gastroesophageal reflux, strictures, and esophageal dysmotility. Up to 2015, 48 cases of eosinophilic esophagitis and esophageal atresia were reported, with dysmotility, reflux, and long-term acid suppression involvement. Prevalent clinical signs include dysphagia, difficulty eating, and reflux symptoms, so an esophagogastroduodenoscopy with biopsy is recommended to rule out associated eosinophilic esophagitis in patients with esophageal atresia and persistent symptoms before performing an esophageal dilation and/or anti-reflux surgery. If eosinophilic esophagitis is confirmed, it should be managed with the corresponding drugs, and the subsequent therapeutic approach will depend on its clinical course.

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Oesophageal atresia and tracheo-oesophageal fistula

Cited by 42 publications

References 10 publications

Update on Foregut Molecular Embryology and Role of Regenerative Medicine Therapies

Update on Foregut Molecular Embryology and Role of Regenerative Medicine Therapies

Esofagitis eosinofílica y atresia esofágica: ¿casualidad o causalidad?

Eosinophilic esophagitis and esophageal atresia: coincidence or causality?

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