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The Long-Gap Esophageal Atresia Problem

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Esophageal and Gastric Disorders in Infancy and Childhood

Abstract

The repair of the most common form of esophageal atresia (EA) with a tracheoesophageal fistula (TEF) from the lower esophageal segment to the trachea is often a pediatric surgeon’s favorite operation. Beginning with a fatal lesion if untreated, the repair requires skill and judgment, and, as an added bonus, the long-term outlook may be essentially normal. For the majority of EA/TEF infants, the operative result is entirely satisfactory and pleases both the families and the surgeon.

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References

  1. Humphreys II GH. The surgical treatment of congenital atresia of the esophagus. Surgery. 1944;15:801–23.

    Google Scholar 

  2. Myers NA. Oesophageal atresia: the epitome of modern surgery. Ann R Coll Surg Engl. 1974;54:277–87.

    CAS  PubMed  PubMed Central  Google Scholar 

  3. Hands LJ, Dudley NE. A comparison between gap length and waterson classifications as guides to mortality and morbidity after surgery for esophageal atresia. J Pediatr Surg. 1986;21:404–6.

    Article  CAS  PubMed  Google Scholar 

  4. Brown AK, Tam PKH. Measurement of gap length in esophageal atresia: a simple predictor of outcome. J Am Coll Surg. 1996;182:41–5.

    CAS  PubMed  Google Scholar 

  5. Ron O, De Coppi P, Pierro A. The surgical approach to esophageal atresia repair and the management of long-gap atresia: results of a survey. Semin Pediatr Surg. 2009;1:44–9.

    Article  Google Scholar 

  6. Spitz L. Esophageal atresia: past, present, and future. J Pediatr Surg. 1996;31:19–25.

    Article  CAS  PubMed  Google Scholar 

  7. Boyle EA, Foker JE. Primary repair of ultra long gap esophageal atresia: results without a lengthening procedure. Ann Thorac Surg. 1994;57:576–9.

    Article  PubMed  Google Scholar 

  8. Upadhyaya V, Gangopadhyaya A, Gupta D, et al. Prognosis of congenital tracheoesophageal fistula with esophageal atresia on the basis of gap length. Pediatr Surg Int. 2007;23:767–71.

    Article  PubMed  Google Scholar 

  9. Coran AG. Ultra-long-gap esophageal atresia: how long is long? Ann Thorac Surg. 1994;57:528–9.

    Article  CAS  PubMed  Google Scholar 

  10. Foker JE, Linden BC, Boyle EM, et al. Development of a true primary repair for the full spectrum of esophageal atresia. Ann Surg. 1997;226:533–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. McKinnon LJ, Kosloske AM. Prediction and prevention of anastomotic complications of esophageal atresia and tracheoesophageal fistula. J Pediatr Surg. 1990;25:778–81.

    Article  CAS  PubMed  Google Scholar 

  12. Mammoto T, Ingber DE. Mechanical control of tissue and organ development. Development. 2010;137:1407–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Foker JE, Kendall TC, Catton K, et al. A flexible approach to achieve a true primary repair for all infants with esophageal atresia. Sem Pediatr Surg. 2005;14:8–15.

    Article  Google Scholar 

  14. Canty Jr TG, Boyle EM, Linden PJ, et al. Aortic arch anomalies associated with long gap esophageal atresia and tracheoesophageal fistula. J Pediatr Surg. 1997;32:1587–91.

    Article  PubMed  Google Scholar 

  15. Gupta DK, Arora M, Srinivas M. Azygos vein anomaly: the best predictor of a long gap in esophageal atresia and tracheoesophageal fistula. Pediatr Surg Int. 2001;17:101–3.

    Article  CAS  PubMed  Google Scholar 

  16. Kulkarni B, Rao RS, Oak S, et al. 13 pairs of ribs – a predictor of long gap atresia in tracheoesophageal fistula. J Pediatr Surg. 1997;32:1453–4.

    Article  CAS  PubMed  Google Scholar 

  17. Hagberg S, Rubenson A, Sillen U, et al. Management of long-gap esophagus: experience with end-to-end anastomosis under maximal tension. Prog Pediatr Surg. 1986;19:89–92.

    Google Scholar 

  18. Howard R, Myers NA. Esophageal atresia: a technique for elongating the upper pouch. Surgery. 1965;58:725–7.

    Google Scholar 

  19. Hendren WH, Hale JR. Electromagnetic bougienage to lengthen esophageal segments in congenital esophageal atresia. N Engl J Med. 1975;293:428–32.

    Article  CAS  PubMed  Google Scholar 

  20. DeLorimier AA, Harrison MR. Long gap esophageal atresia – primary anastomosis after esophageal elongation by bougienage and esophagomyotomy. J Thorac Cardiovasc Surg. 1980;79:138.

    CAS  Google Scholar 

  21. Kleinman PK, Waite RJ, Thomas Cohen I, et al. Atretic esophagus: transgastric balloon-assisted hydrostatic dilation. Radiology. 1989;171:831–3.

    Article  CAS  PubMed  Google Scholar 

  22. Puri P, Ninan GK, Blake NS, et al. Delayed primary anastomosis for esophageal atresia: 18 months’ to 11 years’ follow-up. J Pediatr Surg. 1992;27:1127–30.

    Article  CAS  PubMed  Google Scholar 

  23. Eraklis A, Rossello PJ, Ballantine TVN. Circular esophagomyotomy of upper pouch in primary repair of long-segment esophageal atresia. J Pediatr Surg. 1976;11:709–12.

    Article  CAS  PubMed  Google Scholar 

  24. Janik JS, Filler RM, Ein SH, et al. Long-term follow-up of circular myotomy for esophageal atresia. J Pediatr Surg. 1980;15:835–41.

    Article  CAS  PubMed  Google Scholar 

  25. Gough MH. Esophageal atresia – use of an anterior flap in the difficult anastomosis. J Pediatr Surg. 1980;15:310–1.

    Article  CAS  PubMed  Google Scholar 

  26. Davenport M, Bianchi A. Early experience with oesophageal flap oesophagoplasty for repair of oesophageal atresia. Pediatr Surg Int. 1990;5:332–5.

    Article  Google Scholar 

  27. Sauer H, Kurz R. Experiences in the treatment of esophageal atresia with Rehbein’s Olive technique. Prog Pediatr Surg. 1986;19:93–102.

    Article  CAS  PubMed  Google Scholar 

  28. Siegel M, Sheckelford GD, McAllister WH, et al. Circular esophagus myotomy simulating a pulmonary or mediastinal pseudocyst. Pediatr Radiol. 1980;136:365–8.

    CAS  Google Scholar 

  29. Otte JB, Gianello P, Wese FX, et al. Diverticulum formation after circular myotomy for esophageal atresia. J Pediatr Surg. 1984;19:68–71.

    Article  CAS  PubMed  Google Scholar 

  30. Scharli AF. Esophagus reconstruction by elongation of the lesser gastric curvature. Pediatr Surg Int. 1996;11:214–7.

    Article  CAS  PubMed  Google Scholar 

  31. Maksoud-Filho J, Goncalves MEP, Tannuri U, et al. An exclusively intra-abdominal distal esophageal segment prevents primary delayed anastomosis in children with pure esophageal atresia. J Pediatr Surg. 2002;37:1521–5.

    Article  PubMed  Google Scholar 

  32. Myers NA, Beasley SW, Auldist AW, et al. Oesophageal atresia without fistula – anastomosis or replacement. Pediatr Surg Int. 1987;2:216–22.

    Google Scholar 

  33. Ein SH, Shandling B, Heiss K. Pure esophageal atresia: outlook in the 1990s. J Pediatr Surg. 1993;28:1147–50.

    Article  CAS  PubMed  Google Scholar 

  34. Holland A, Ron O, Pierro A, et al. Surgical outcomes of esophageal atresia without fistula for 24 years at a single institution. J Pediatr Surg. 2009;44:1928–32.

    Article  PubMed  Google Scholar 

  35. Spitz L. Oesophageal atresia treatment: a 21st-centruy perspective. J Pediatr Gastroenterol Nutr. 2011;52:S12.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota Medical School, Mayo Mail Code Box 207, 420 Delaware St SE, Minneapolis, MN, 55455, USA

    John E. Foker MD, PhD (Robert and Sharon Kaster Professor of Surgery, Visiting Professor)

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

    John E. Foker MD, PhD (Robert and Sharon Kaster Professor of Surgery, Visiting Professor)

Authors
  1. John E. Foker MD, PhD
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Correspondence to John E. Foker MD, PhD .

Editor information

Editors and Affiliations

  1. Medical University of Graz, Graz, Austria

    Holger Till

  2. Sheffield Children’s Hospital, Paediatric Gastroenterology Centre, Sheffield, United Kingdom

    Mike Thomson

  3. Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA

    John E. Foker

  4. Department Surgery, University of Missouri, Kansas City Children’s Mercy Hospital, Kansas City, Missouri, USA

    George W. Holcomb III

  5. University of Arizona, Tucson, Arizona, USA

    Khalid M. Khan

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Foker, J.E. (2017). The Long-Gap Esophageal Atresia Problem. In: Till, H., Thomson, M., Foker, J., Holcomb III, G., Khan, K. (eds) Esophageal and Gastric Disorders in Infancy and Childhood. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-11202-7_20

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  • DOI: https://doi.org/10.1007/978-3-642-11202-7_20

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-11201-0

  • Online ISBN: 978-3-642-11202-7

  • eBook Packages: MedicineMedicine (R0)

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