Abstract
During the period 1984–1989, 25 infants with oesophageal atresia and tracheo-oesophageal fistula underwent primary oesophageal anastomosis incorporating a full-thickness pedicle oesophageal flap from the dilated upper oesophageal pouch. Use of the flap creates a wide, oblique anastomosis in all instances. Where a large “gap” is present after full mobilisation, the flap can be tubed as a neo-oesophagus to bridge the defect without tension. The early complication rate was high (leakage 28%, recurrent tracheoesophageal fistula 8%), reflecting the development of a novel technique. Despite complications, however, 92% of infants retained their oesophagus and have no long-term swallowing problems.
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References
Bar-Moar JA, Shoshany G, Sweed Y (1989) Wide gap esophageal atresia: a new method to elongate the upper pouch. J Pediatr Surg 24: 882–883
Ein S, Shandling B, Stephens CA (1984) 21 year experience with the pediatric gastric tube. J Pediatr Surg 22: 77–81
Gough MH (1980) Esophageal atresia — use of an anterior flap in the difficult anastomosis. J Pediatr Surg 15: 310–311
Haight C, Towsley H (1943) Congenital atresia of the esophagus with tracheosophageal fistula: extrapleural ligation of fistula and end-to-end anastomosis of esophageal segments. Surg Gynecol Obstet 76: 672–688
Hicks LM, Mansfield PB (1981) Esophageal atresia and tracheoesophageal fistula. J Thorac Cardiovasc Surg 81: 358–363
Lister J (1964) The blood supply of the oesophagus in relation to oesophageal atresia. Arch Dis Child 39: 131–137
Livaditis A (1973) Esophageal atresia: a technique for overbridging large segmental gaps. Z Kinderchir 13: 298–306
Louhimo I, Lindahl H (1983) Esophageal atresia: primary results of 500 consecutively treated patients. J Pediatr Surg 18: 217–229
Mitchell IM, Goh DW, Roberts KD, Abrams LD (1989) Colon interposition in children. Br J Surg 76: 681–686
O'Neill JA, Holcolm GW, Neblett WW (1982) Recent experience with esophageal atresia. Ann Surg 195: 739–745
Silain U, Hagberg S, Rubenson A (1988) Management of esophageal atresia: review of 16 years′ experience. J Pediatr Surg 23: 805–809
Spitz L (1984) Gastric transposition via the mediastinal route for infants with long-gap esophageal atresia. J Pediatr Surg 19: 149–154
Spitz L, Kiely E, Brereton RJ (1987) Esophageal atresia: five-year experience with 148 cases. J Pediatr Surg 22: 103–108
Sulamaa M, Gripenberg L, Alvenainen EK (1951) Prognosis and treatment of congenital atresia of the esophagus. Acta Chir Scand 102: 141–157
Ten Kate J (1952) A method of suturing in operations for congenital oesophageal atresia. Arch Chir Neder 4: 43–47
Touloukian RJ (1981) Long-term results following repair of esophageal atresia by end-to-side anastomosis and ligation of the tracheoesophageal fistula. J Pediatr Surg 16: 983–987
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Davenport, M., Bianchi, A. Early experience with oesophageal flap oesophagoplasty for repair of oesophageal atresia. Pediatr Surg Int 5, 332–335 (1990). https://doi.org/10.1007/BF00177099
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DOI: https://doi.org/10.1007/BF00177099