Abstract
INoEA is the International Network of Esophageal Atresia and consists of a broad spectrum of pediatric specialties and patient societies. The working group on long-gap esophageal atresia (LGEA) set out to develop guidelines regarding the definition of LGEA, the best diagnostic and treatment strategies, and highlight the necessity of experience and communication in the management of these challenging patients. Review of the literature and expert discussion concluded that LGEA should be defined as any esophageal atresia (EA) that has no intra-abdominal air, realizing that this defines EA with no distal tracheoesophageal fistula (TEF). LGEA is considerably more complex than EA with distal TEFs and should be referred to a center of expertise. The first choice is to preserve the native esophagus and pursue primary repair, delayed primary anastomosis, or traction/growth techniques to achieve anastomosis. A cervical esophagostomy should be avoided if possible. Only if primary anastomosis is not possible, replacement techniques should be used. Jejunal interposition is proposed as the best option among the major EA centers. In light of the infrequent occurrence of LGEA and the technically demanding techniques involved to achieve esophageal continuity, it is strongly advised to develop regional or national centers of expertise for the management and follow-up of these very complex patients.
| Original language | English |
|---|---|
| Article number | 63 |
| Journal | Frontiers in Pediatrics |
| Volume | 5 |
| DOIs | |
| Publication status | Published - Mar 31 2017 |
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Keywords
- Centers of expertise
- Definition
- Diagnosis
- Long-gap esophageal atresia
- Management
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
Cite this
Position paper of INoEA working group on long-gap Esophageal Atresia : For better care. / van der Zee, David C.; Bagolan, Pietro; Faure, Christophe; Gottrand, Frederic; Jennings, Russell; Laberge, Jean Martin; Martinez Ferro, Marcela Hernan; Parmentier, Benoît; Sfeir, Rony; Teague, Warwick.
In: Frontiers in Pediatrics, Vol. 5, 63, 31.03.2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Position paper of INoEA working group on long-gap Esophageal Atresia
T2 - For better care
AU - van der Zee, David C.
AU - Bagolan, Pietro
AU - Faure, Christophe
AU - Gottrand, Frederic
AU - Jennings, Russell
AU - Laberge, Jean Martin
AU - Martinez Ferro, Marcela Hernan
AU - Parmentier, Benoît
AU - Sfeir, Rony
AU - Teague, Warwick
PY - 2017/3/31
Y1 - 2017/3/31
N2 - INoEA is the International Network of Esophageal Atresia and consists of a broad spectrum of pediatric specialties and patient societies. The working group on long-gap esophageal atresia (LGEA) set out to develop guidelines regarding the definition of LGEA, the best diagnostic and treatment strategies, and highlight the necessity of experience and communication in the management of these challenging patients. Review of the literature and expert discussion concluded that LGEA should be defined as any esophageal atresia (EA) that has no intra-abdominal air, realizing that this defines EA with no distal tracheoesophageal fistula (TEF). LGEA is considerably more complex than EA with distal TEFs and should be referred to a center of expertise. The first choice is to preserve the native esophagus and pursue primary repair, delayed primary anastomosis, or traction/growth techniques to achieve anastomosis. A cervical esophagostomy should be avoided if possible. Only if primary anastomosis is not possible, replacement techniques should be used. Jejunal interposition is proposed as the best option among the major EA centers. In light of the infrequent occurrence of LGEA and the technically demanding techniques involved to achieve esophageal continuity, it is strongly advised to develop regional or national centers of expertise for the management and follow-up of these very complex patients.
AB - INoEA is the International Network of Esophageal Atresia and consists of a broad spectrum of pediatric specialties and patient societies. The working group on long-gap esophageal atresia (LGEA) set out to develop guidelines regarding the definition of LGEA, the best diagnostic and treatment strategies, and highlight the necessity of experience and communication in the management of these challenging patients. Review of the literature and expert discussion concluded that LGEA should be defined as any esophageal atresia (EA) that has no intra-abdominal air, realizing that this defines EA with no distal tracheoesophageal fistula (TEF). LGEA is considerably more complex than EA with distal TEFs and should be referred to a center of expertise. The first choice is to preserve the native esophagus and pursue primary repair, delayed primary anastomosis, or traction/growth techniques to achieve anastomosis. A cervical esophagostomy should be avoided if possible. Only if primary anastomosis is not possible, replacement techniques should be used. Jejunal interposition is proposed as the best option among the major EA centers. In light of the infrequent occurrence of LGEA and the technically demanding techniques involved to achieve esophageal continuity, it is strongly advised to develop regional or national centers of expertise for the management and follow-up of these very complex patients.
KW - Centers of expertise
KW - Definition
KW - Diagnosis
KW - Long-gap esophageal atresia
KW - Management
UR - http://www.scopus.com/inward/record.url?scp=85033383136&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85033383136&partnerID=8YFLogxK
U2 - 10.3389/fped.2017.00063
DO - 10.3389/fped.2017.00063
M3 - Article
AN - SCOPUS:85033383136
VL - 5
JO - Frontiers in Pediatrics
JF - Frontiers in Pediatrics
SN - 2296-2360
M1 - 63
ER -