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Pediatric Surgery International

, Volume 34, Issue 1, pp 63–69 | Cite as

Esophagoesophagopexy technique for assisted fistulization of esophageal atresia

  • Isabelle Chumfong
  • Hanmin Lee
  • Benjamin E. Padilla
  • Tippi C. MacKenzie
  • Lan T. Vu
Original Article
  • 238 Downloads

Abstract

Purpose

We describe our experience using a modified suture fistula technique for addressing tension in longer gap esophageal atresia (EA). Esophagoesophagopexy (EEP) is the tacking of the proximal and distal ends of esophageal pouches without formal anastomosis. In this retrospective cohort, we review the outcomes of patients with EA after EEP.

Methods

We reviewed the operative reports of EA cases treated at our institution from 1997 to 2016 and identified all patients described as having EEP.

Results

Of 129 EA cases, five patients underwent EEP. Formal anastomosis was not done due to patient’s instability, prematurity, or long gap. Median birth weight was 1.4 kg (0.6–2.2 kg), and median gestational age at birth was 29 weeks (25–34 weeks). Age at time of EEP ranged 0–5 months. Esophagoesophageal fistula was confirmed in three patients. All three had strictures requiring weekly dilations. One of these patients died. The two surviving patients underwent fundoplication.

Conclusion

We describe an alternative technique for esophageal anastomosis in patients for whom a standard anastomosis is not possible. EEP can lead to a functional anastomosis through fistulization and avoid the morbidity of multiple thoracotomies and lengthening procedures. Families should be educated on the potential need for dilations and antireflux procedures.

Keywords

Esophageal atresia Long gap esophageal atresia Esophageal anastomosis Esophagoesophagopexy Suture fistula 

Abbreviations

EA

Esophageal atresia

EEP

Esophagoesophagopexy

EEF

Esophagoesophageal fistula

TEF

Tracheoesophageal fistula

Notes

Compliance with ethical standards

Funding

This work was supported by the National Institutes of Health [5T32DK007573-27].

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Isabelle Chumfong
    • 1
  • Hanmin Lee
    • 1
  • Benjamin E. Padilla
    • 1
  • Tippi C. MacKenzie
    • 1
  • Lan T. Vu
    • 1
  1. 1.Division of Pediatric SurgeryUniversity of California San FranciscoSan FranciscoUSA

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