Elongation of esophageal segments by bougienage stretching technique for long gap esophageal atresia to achieve delayed primary anastomosis by thoracotomy or thoracoscopic repair: A first experience from China

The treatment of long gap esophageal atresia (LGEA) is one of the most challenging congenital malformations in neonatal surgery. A preoperative bougienage stretching technique for elongation of the two segments of esophagus is applied to achieve utilizing the native esophagus to establish esophageal...

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Bibliographic Details
Published in:Journal of pediatric surgery 2018-08, Vol.53 (8), p.1584-1587
Main Authors: Sun, Suna, Pan, Weihua, Wu, Wenjie, Gong, Yiming, Shi, Jia, Wang, Jun
Format: Article
Language:English
Subjects:
Anastomosis, Surgical - methods
Bougienage stretching technique
China
Digestive System Surgical Procedures
Dilatation - methods
Elongation
Esophageal Atresia - surgery
Female
Humans
Infant
Infant, Newborn
Long gap esophageal atresia (LGEA)
Preoperative Care - methods
Thoracoscopic approach
Thoracotomy - methods
Treatment Outcome
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Summary:The treatment of long gap esophageal atresia (LGEA) is one of the most challenging congenital malformations in neonatal surgery. A preoperative bougienage stretching technique for elongation of the two segments of esophagus is applied to achieve utilizing the native esophagus to establish esophageal continuity by open or thoracoscopic approach. From January 2015 to May 2017, 12 neonates who suffered from LGEA were admitted to our department. They were divided into 2 groups (A and B) according to their admission time. They all accepted bougienage stretching technique before esophageal anastomosis. Initially the lengths of esophageal gap in 12 infants ranged from 4 to 7.5 vertebral bodies (M=5.8±1.1). The gap lengths became –1 to 2.5 vertebral bodies after bougienage stretching technique and tension-free anastomosis were performed successfully for all 12 cases: Group A (n=5) by thoracotomy and group B (n=7) by thoracoscopic approach. 12 cases have been followed up for 1–25 months (M=12.4±8.5) after definitive surgery. Bougienage stretching technique for LGEA is feasible with satisfactory clinical results. Thoracoscopic approach is a good choice for primary anastomosis in LGEA. Treatment Study Level IV
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2017.12.009