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Long Gap oesoohageal atresia

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By Cristobal Adolfo Abello Munarriz Pediatric surgeon
Pranas Gurskas, Aidas Ivanauskas
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...
2002: Medicina
F Canavese, L Valfrè, S Vinardi, M G Cortese, S Costantino, R Macchieraldo, E Bianco
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...
February 2009: Minerva Pediatrica
A T Hadidi
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...
August 2007: European Journal of Pediatric Surgery
W Sigge, H Würtenberger, A Franz, M Albrecht
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...
February 1986: Surgery in Infancy and Childhood
A Pineschi, M Pini, G Torre, N Levi
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...
February 1985: Surgery in Infancy and Childhood
D G Young
No abstract text is available yet for this article.
May 1967: British Journal of Surgery
B Debras, O Kanane, B Enon, M Robert
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.
October 1996: European Journal of Pediatric Surgery
P Lyall, Q Bao-Quan, S Beasley
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...
March 2001: Pediatric Surgery International
S W Beasley, F A Shann, N A Myers, A W Auldist
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...
May 1, 1989: Medical Journal of Australia
Chih-Cheng Luo, Jer-Nan Lin, Chao-Ran Wang
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...
November 2002: European Journal of Pediatrics
F Schier, G H Willital
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...
October 1988: Surgery in Infancy and Childhood
M Zer, E Freud, S Grozovski
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.
May 1997: Thorax
Antti Koivusalo, Mikko P Pakarinen, Risto J Rintala
BACKGROUND AND AIM: Gastrooesophageal reflux (GER) is common in patients with oesophageal atresia (OA). Complicated GER often manifests itself early after the primary repair (PR) and frequently requires antireflux surgery (ARS). How many patients will be later affected is unknown. We conducted an objective long-term follow-up for the cumulative incidence of OA-associated GER based on pH-metry and histology. MATERIALS AND METHODS: Sixty-one consecutive patients with their native oesophagus, who underwent PR for OA with a distal fistula from 1989 to 2004, were included...
February 2007: Journal of Pediatric Surgery
Lewis Spitz
A brief resume of the highlights in the history of oesophageal atresia is presented. This is followed by research into the etiology, ontogeny and embryology, and microbiological studies. A revised classification of risk factors with consequent survival statistics is presented. Lessons learned in the management of the condition over a 40-year period are reported with particular emphasis on the management of the preterm infant with associated severe respiratory distress, right-side aortic arch, upper pouch fistula, 'long-gap' atresia, and the use of gastrostomy and intercostals drains...
October 2006: Journal of Pediatric Surgery
L Lindell-Iwan
A modification of Livaditis' myotomy to bridge a long gap oesophageal atresia is presented. The wide hypertrophic oral segment is lengthened with several horizontal incisions through the muscle layer. These incisions are made in a network of several rows without perforating the mucosa. The thick, broad oral segment becomes longer and narrower and fits better for anastomosis with the smaller distal segment. Pocket formations and diverticula can thus be avoided.
1990: Annales Chirurgiae et Gynaecologiae
G S Arul, D Parikh
INTRODUCTION: The usual indications for oesophageal replacement in childhood are intractable corrosive strictures and long-gap oesophageal atresia. Generally, paediatric surgeons attempt to preserve the native oesophagus with repeat dilatations. However, when this is not successful, an appropriate conduit must be fashioned to replace the oesophagus. The neo-oesophagus should allow normal oral feeding, not have gastro-oesophageal reflux, and be able to function well for the life-time of the patient...
January 2008: Annals of the Royal College of Surgeons of England
J A Cauchi, R G Buick, P Gornall, M H Simms, D H Parikh
In children, the indications for oesophageal substitution are principally, long gap oesophageal atresia (OA), severe anastomotic disruption following primary repair of OA and severe caustic or peptic strictures. We present an outcome review of eight cases who underwent oesophageal substitution with jejunum at our institution between 1986 and 2001. The purpose of this study was to evaluate our experience with free/pedicled jejunal grafts and its long-term outcome as an oesophageal substitute. Operative and postoperative outcome with free and pedicled jejunal grafts in four cases of pure OA, two cases of OA and distal tracheo-oesophageal fistula (TOF), one patient with a high retrolaryngeal oesophageal web and one case of severe caustic oesophageal stricture...
January 2007: Pediatric Surgery International
C Cannizzaro, M Boglione, S Rodríguez, A Reussman, M Martínez Ferro
INTRODUCTION: Esophageal atresia (EA) is one of the most prevalent surgical conditions in the newborn. Sometimes early oesophageal anastomosis can't be done due to the esophageal gap. Long gap (LG) definition is not precise. Although consensus exist about conservation of owns esophagus is the best therapeutic option, literature is not clear about how long and under what circunstances is advisable to wait for the spontaneous esophageal pouches to growth (P. Puri approach). Furthermore at present we don't even know the real repercussion that this waiting can implicate...
October 2009: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
B M Ure, E Slany, E P Eypasch, M Gharib, A M Holschneider, H Troidl
Out of a series of 146 patients with oesophageal atresia 9 (6.2%) underwent colon interposition from 1963 to 1971. All eight surviving patients were seen at follow-up after a mean of 22 years. Three patients were free of specific symptoms according to the criteria of DeMeester, two had moderate and three severe distress. The mean time for consuming a standardized test meal was 15 minutes, compared to 8 minutes in healthy controls. Patients required 1-9 minutes to transport liquid barium through the transplant, compared to < 10 seconds in control subjects...
August 1995: European Journal of Pediatric Surgery
A D Hawley
Oesophageal atresia (OA) is a congenital anomaly in which the oesophagus ends in a blind upper pouch. Specialised family-centred nursing care is required for the neonate/infant with 'long-gap' OA. Goals of preoperative nursing care focus on prevention of aspiration, optimising nutrition and thus growth of the baby and supporting parents. Primary repair is delayed to enable further growth of the infant and additional oesophageal growth. Additional nursing and medical research needs to be undertaken in a number of areas relating to the management of infants with long-gap OA...
2001: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
2016-09-04 15:25:11
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