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Super Charged Jejunal Tube (Microvascular Anastomosis)

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Esophageal Preservation and Replacement in Children

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Abstract

Long-gap esophageal atresia (LGEA) in children poses significant functional and psychosocial challenges. A number of techniques to address LGEA include primary repair, esophageal traction-induced growth (e.g., Foker procedure) or esophageal replacements with stomach (gastric pull-up), small bowel or colonic interpositions; however, each of these approaches has limitations and may not be indicated for all LGEA patients. Of the esophageal replacements, the supercharged pedicled jejunal interposition (SPJI) is a technique which offers a number of advantages over the stomach or colon as conduits when the native esophagus cannot be used. SPJI interposes a segment of jejunum, keeping the distal jejunum connected to its native blood supply, while “supercharging” the transposed segment using neck or intrathoracic vessels to augment perfusion following transposition. SPJI is a technically complex and intensive intervention necessitating a multidisciplinary team approach. Recent studies support SPJI as a viable and safe option for children with LGEA who have failed previous reconstructive techniques. In addition, SPJI may provide a better long-term solution to LGEA in children where esophageal conduits must remain intact and functional for decades.

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Authors and Affiliations

  1. Department of Plastic and Oral Surgery, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Shannon M. Malloy, Laura C. Nuzzi, Amir H. Taghinia & Brian I. Labow

  2. Department of Surgery, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Benjamin Zendejas

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  1. Shannon M. Malloy
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  2. Laura C. Nuzzi
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  3. Benjamin Zendejas
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  4. Amir H. Taghinia
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  5. Brian I. Labow
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Corresponding author

Correspondence to Brian I. Labow .

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Editors and Affiliations

  1. Professor of surgery and Pediatrics, University of Wisconsin-Madison, Marshfield Children’s Hospital, Marshfield, WI, USA

    Ashwin Pimpalwar

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Malloy, S.M., Nuzzi, L.C., Zendejas, B., Taghinia, A.H., Labow, B.I. (2021). Super Charged Jejunal Tube (Microvascular Anastomosis). In: Pimpalwar, A. (eds) Esophageal Preservation and Replacement in Children. Springer, Cham. https://doi.org/10.1007/978-3-030-77098-3_14

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  • DOI: https://doi.org/10.1007/978-3-030-77098-3_14

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