Long Gap oesoohageal atresia

AIM: This study was aimed at identifying factors which may affect the gap length in cases of esophageal atresia with tracheoesophageal fistula (EA-TEF) and whether gap length plays any role in determining the outcome. MATERIALS AND METHODS: All consecutive cases of EA-TEF were included and different patient parameters were recorded. Plain radiographs with a nasogastric tube in the upper esophagus were taken. Patients were grouped into T1-T2; T2-T3; T3-T4; and T4 depending on the thoracic vertebral level of the arrest of the tube...

INTRODUCTION:  The aim of this study was to stratify anastomotic strictures (AS) following esophageal atresia (EA) repair and to establish predictors for the need of dilations. MATERIALS AND METHODS:  A retrospective study on children operated on for EA between 2004 and 2014 was conducted. The stricture index (SI) was measured both radiologically (SIXR ) and endoscopically (SIEND ). A correlation analysis between the SI and the number of dilations was performed using Spearman's test and linear regression analysis...

BACKGROUND: Fundoplication has been performed almost universally in children treated with the Foker procedure (FP) for long gap esophageal atresia (LGEA). We report our experience with pharmacological management and endoscopic surveillance rather than early routine fundoplication in infants treated with the FP. METHODS: A retrospective chart review was performed of all children treated with the Foker procedure at our institution. RESULTS: Nine children have undergone the FP since 2007...

PURPOSE: The aim of this study is to identify the risk factors for esophageal anastomotic stricture (EAS) and/or anastomotic leakage (EAL) after primary repair of esophageal atresia with tracheoesophageal fistula (EA/TEF) in infants. METHODS: A retrospective chart review of 52 patients with congenital EA/TEF between January 2000 and December 2015 was conducted. Univariate and multivariate analyses were performed to identify the risk factors for anastomotic complications...

UNLABELLED: We present the results of the validation of an inanimate model created for training thoracoscopic treatment of esophageal atresia with lower tracheoesophageal fistula (EA/TEF). MATERIALS AND METHODS: We used different domestic materials such as a piece of wood (support), corrugated plastic tubes (PVC) of different sizes to simulate ribs, intercostal spaces, trachea and spine and tubular latex balloons to simulate the esophagus and lungs to make the basic model...

OBJECTIVES: The aim of the study was to evaluate and study the full spectrum of swallowing dysfunction and long-term disease-specific outcomes in adults with surgically corrected esophageal atresia/tracheaesophageal fistula (EA/TEF). BACKGROUND: Long-term outcomes for adults who underwent EA/TEF repair because infants are lacking. METHODS: We developed a disease-specific swallowing dysfunction questionnaire (SDQ) to assess swallowing dysfunction and quality of life (QOL) of adult patients with surgically corrected EA/TEF...

Background  Since 2005, infants with esophageal atresia (EA) in our unit are given prophylactic proton pump inhibitors (PPI) after repair until 1 year of age. The aims of this study were to identify risk factors for anastomotic strictures (AS) and to assess the efficacy of postoperative PPI prophylaxis in reducing the incidence of AS compared with symptomatic PPI. Methods  Patients who underwent EA repair from 1994 to 2013 in our unit were included in this retrospective observational study approved by the local ethics review board...

BACKGROUND: The treatment of long-gap esophageal atresia remains an issue for pediatric surgeons. Many techniques for treating long-gap esophageal atresia have been proposed, but the optimal method has not been established. The thoracoscopic esophageal elongation technique has recently been developed. We previously reported a case in which two-stage thoracoscopic repair was performed using internal esophageal traction without esophageal tearing, and we retrospectively reviewed the outcomes of this procedure in this study...

Main problem in treating newborns with congenital esophageal atresia is a long gap between esophageal segments. There are many publications that describe various techniques of esophageal anastomosis. In our report we observed spontaneous racanalisation of the esophagus. This study reports 3 similar clinical pictures of patients, received and treated in our clinics for III-b type oesophageal atresia (esophageal atresia with distal tracheoesophageal fistula). All newborns were operated, two patients underwent palliative procedures, leaving a diastasis between esophageal pouches, and lining a vicryl string between oesophageal ends; and in one case attempt of primary oesophageal anastomosis turned in to leakage of anastomosis and mediastinitis...

An extremely rare case of type A esophageal atresia is reported. The baby girl patient born spontaneously after a 38-week pregnancy, was diagnosed prenatally with suspected type A esophageal atresia. Diagnosis was confirmed at birth by chest and abdominal X-ray. As per protocol, a naso-esophageal tube was positioned in aspiration and a Stamm gastrostomy made for nutritional purposes. Evaluation of the distance between blind pouches at one month of life showed they were overlapping. At intervention the pouches were found to be united by a fibrous bridge about 1...

AIM: The management of long gap oesophageal atresia remains a major challenge for the paediatric surgeon. In this experimental study on neonatal lambs, a Silastic tube was used to bridge a gap in the oesophagus. The Silastic tube was not fixed to the oesophageal edges but half a centimetre from the edge of the oesophagus. The oesophageal edges were left free to grow over the Silastic tube and bridge the gap. The aim of the study was to see whether the oesophageal edges would grow over the Silastic tube and form a continuous oesophagus...

During the last 12 years, operations were performed on 144 infants with oesophageal atresia. In 18 of them who were suffering from an atresia with long gap between segments, perlon threads were laid surgically. Continuity of the oesophagus was attempted using Rehbein's technique. The newborn had type II and IIIb atresia according to Vogts' classification. 11 of these 18 infants survived the third week of life. The fibroepithelial canal that had developed along the perlon thread, was dilated in steps in 6. The clinical course and results are reported...

In 1982 a programme of multi-disciplinary follow-up on 12 patients that underwent a gastric tube oesophagoplasty for long-gap oesophageal atresia was started. Radiological examination, performed on all gastric tubes but one (died a few days after surgery), assessed the morphology and dynamics of gastric tube, either distally or proximally based, and stomach 2 to 8 years after surgery. Endoscopic backward exploration was performed on 7 cases, to allow a closer analysis of stomach, gastric tube mucosa and upper oesophageal stump, demonstrating that the gastric transplant is viable and almost undamaged...

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A 22-year-old man developed severe haematemesis 21 years after colon interposition for long-gap oesophageal atresia. A fistula, from an anastomotic ulcer to the descending thoracic aorta, was discovered and treated successfully by surgical resection. This previously unreported complication highlights the need for the prevention of peptic complications following oesophageal replacement in children.

The indications for postoperative ventilation and paralysis with neck flexion after repair of oesophageal atresia (OA) have been controversial, mainly because of a paucity of information on oesophageal compliance and the influence of posture on anastomotic tension. This study using a pig model demonstrates that 78.8% of oesophageal lengthening occurs between full flexion and the neutral position, contributing to an increase in oesophageal length of about 9%. Compliance of the oesophagus is a linear function of the natural log of the tension applied...

Since 1948, when the first patient with oesophageal atresia and a tracheo-oesophageal fistula was treated successfully at the Royal Children's Hospital, Melbourne, 569 infants with one or both conditions have been managed at that institution. The mortality rate in those in whom surgical repair of the oesophageal atresia and distal tracheo-oesophageal fistula was attempted has declined from 55% in the first 10 years to less than 1% in the last 10 years of the series. Earlier diagnosis and improvements in resuscitation, transport, neonatal intensive care, anaesthesia, the treatment of associated anomalies and surgical technique all are likely to have contributed to the decline in the mortality and morbidity rates...

UNLABELLED: During the last decade, an increasing number of paediatric surgeons have chosen to perform a delayed oesophageal anastomosis for oesophageal atresia (OA) without tracheo-oesophageal fistula (TOF). The gap between the two oesophageal pouches is an important determinant in the surgical management of these patients. We describe a new method using spiral computed tomography (CT) to evaluate the gap between the proximal and distal oesophageal pouches. In our last four cases of OA without TOF, Stamm gastrostomy was performed soon after birth...

A new mechanical device is presented which approximates the two oesophageal pouches in long gap oesophageal atresia and possibly creates an anastomosis. The principle is similar to magnetic bougienage, only that purely mechanical force is employed instead. This offers several advantages: the instrument is considerably less bulky, technically simple, inexpensive, light and therefore easy to transport. Only normal electrical current is necessary. The tensile forces applied are easier to control. The child does not have to be placed inside a tube and is not restrained in its movements...

Two patients with refractory anastomotic stenosis and symptomatic ballooning of the upper oesophageal pouch following repair of long gap oesophageal atresia are described. In both cases a circular myotomy had been used to elongate the proximal oesophageal segment at the time of primary repair. Both patients were successfully treated by Y-V plasty of the oesophageal stenosis and tailoring of the dilated segment.