Scoliosis after thoracotomy repair of esophageal atresia: a systematic review

Mishra, Prabal; Tinawi, Georges; Stringer, Mark D.

doi:10.1007/s00383-020-04683-3

Cited by 20 publications

(8 citation statements)

References 31 publications

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“…As thoracoscopy is less invasive, it could greatly reduce the rate of orthopedic malformation caused by surgery in the long term. 40 Our study is one of the first to compare the outcome of long gap EA according to a conservative or replacement surgical approach. Although the conservative group differs from the replacement group in terms of birth weight and weight at surgery, we found, as expected, that anastomotic stenosis and feeding disorders are more frequent in the conservative group.…”

Section: Discussionmentioning

confidence: 99%

Outcome of long gap esophageal atresia at 6 years: A prospective case control cohort study

BOURG¹,

Gottrand²,

Parmentier³

et al. 2023

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

Outcome of long gap esophageal atresia at 6 years: A prospective case control cohort study

BOURG¹,

Gottrand²,

Parmentier³

et al. 2023

Journal of Pediatric Surgery

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“…An additional thoracotomy would have potentially placed her at risk for well-known sequelae resulting from repeat thoracotomy, such as rib fusion, scoliosis, and nerve injury leading to scapula alata. 1,2,12 With the proposed magnetic compression anastomosis approach, an expected avoidance of multiple highly invasive procedures and the potential to minimize harm to the patient served as the basis for compassionate care justification, according to the principles of our university's ethical review board.…”

Section: Discussionmentioning

confidence: 99%

“…Repeated thoracotomies carry the risk of lung injury, rib fusion, scoliosis, and other musculoskeletal disorders that can compromise the longterm goals of functional normalcy. 1,2 The Connect-EA (Myka Laboratories, San Francisco, California, United States) device is a pair of uniquely engineered magnetic anchors designed to create an esophageal anastomosis within 8 to 10 days after placement. They have been tested extensively in animal studies 3,4 before using them in select clinical cases.…”

Section: Introductionmentioning

confidence: 99%

Repair of Complex Esophageal Atresia with Tracheobronchial Remnant using Special Magnets

Reich,

Weigl,

Holler

et al. 2024

European J Pediatr Surg Rep.

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Esophageal atresia (EA) repair can be complicated by associated malformations such as a tracheobronchial remnant in the distal esophagus. We describe our experience with a patient found to have long-gap EA with a distal cartilaginous ring who was managed using a combination of esophageal lengthening and magnetic compression anastomosis. A 5-month-old girl was referred to us from an outside hospital with type C EA including a very high upper pouch. She had undergone a prior thoracotomy with fistula ligation during which a clip was placed on the lower esophagus, leaving a 2-cm diverticulum on the trachea and a short lower esophageal pouch. Upon endoscopic evaluation at our center, we found a tracheobronchial remnant in the lower esophagus between the clip and the carina. An open thoracotomy was performed to approximate the esophageal pouches and a magnet anchor (Connect EA, Myka Laboratories, San Francisco, California, United States) was placed retrograde through the distal esophageal cartilaginous ring into the lower pouch. On postoperative day 8, after adequate growth and decreased pouch tension, a second magnetic anchor was placed endoscopically to the upper pouch to mate with the previously placed lower pouch anchor. The anastomosis formed within 14 days. Due to the tracheobronchial remnant, the device did not pass distally and was removed endoscopically. On postoperative day 8, balloon dilation of the anastomosis and tracheobronchial remnant was performed. Subsequently, the patient required a total of 6 dilations in an 18-month follow-up. This case report illustrates the utility of using magnets to create an esophageal anastomosis in complex cases of EA with concomitant esophageal malformations. The parents of the patient gave their written consent to publish this technical report.

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“…In the cohort reported by Di Natale et al [10], rib fusions and winged scapula were reported more frequently in subjects aged above 18 years old than in other age groups; probably in this group thoracoscopy or muscle-sparing thoracotomy were performed less often. In a recent systematic review [33], secondary scoliosis after thoracotomy repair in EA children is reported in 13% of cases; according to a meta-analysis by Drevin et al [34], musculoskeletal complications are less common with the thoracoscopic approach. Considering only adult patients, a study by Sistonen et al [35] reported a 13-fold risk of scoliosis compared to the general population, with rib fusions post-thoracotomy being the strongest predictive factor; however, spinal surgery was never needed.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of long term follow-up and transitional care in adolescents and adults with esophageal atresia - why is transitional care mandatory?

et al. 2023

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Purpose: to review recent literature concerning long-term health issues and transitional care in esophageal atresia (EA) patients. PubMed, Scopus, Embase and Web of Science databases were screened for studies regarding EA patients aged more than or equal to 11 years, published between August 2014 and June 2022. Sixteen studies involving 830 patients were analyzed. Mean age was 27.4 years (range 11–63). EA subtype distribution was: type C (48.8%), A (9.5%), D (1.9%), E (0.5%) and B (0.2%). 55% underwent primary repair, 34.3% delayed repair, 10.5% esophageal substitution. Mean follow-up was 27.2 years (range 11–63). Long-term sequelae were: gastro-esophageal reflux (41.4%), dysphagia (27.6%), esophagitis (12.4%), Barrett esophagus (8.1%), anastomotic stricture (4.8%); persistent cough (8.7%), recurrent infections (4.3%) and chronic respiratory diseases (5.5%). Musculo-skeletal deformities were present in 36 out of 74 reported cases. Reduced weight and height were detected in 13.3% and 6% cases, respectively. Impaired quality of life was reported in 9% of patients; 9.6% had diagnosis or raised risk of mental disorders. 10.3% of adult patients had no care provider. Meta-analysis was conducted on 816 patients. Estimated prevalences are: GERD 42.4%, dysphagia 57.8%, Barrett esophagus 12.4%, respiratory diseases 33.3%, neurological sequelae 11.7%, underweight 19.6%. Heterogeneity was substantial (> 50%). Conclusion: EA patients must continue follow-up beyond childhood, with a defined transitional-care path by a highly specialized multidisciplinary team due to the multiple long-term sequelae. What is Known:• Survival rates of esophageal atresia patients is now more than 90% thanks to the improvements in surgical techniques and intensive care, therefore patients’ needs throughout adolescence and adulthood must be taken into account. What is New:• This review, by summarizing recent literature concerning long term sequelae of esophageal atresia, may contribute to raise awareness on the importance of defining standardized protocols of transitional and adulthood care for esophageal atresia patients.

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Scoliosis after thoracotomy repair of esophageal atresia: a systematic review

Cited by 20 publications

References 31 publications

Outcome of long gap esophageal atresia at 6 years: A prospective case control cohort study

Outcome of long gap esophageal atresia at 6 years: A prospective case control cohort study

Repair of Complex Esophageal Atresia with Tracheobronchial Remnant using Special Magnets

Systematic review of long term follow-up and transitional care in adolescents and adults with esophageal atresia - why is transitional care mandatory?

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