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Esophageal and Gastric Disorders in Infancy and Childhood pp 221–227Cite as

Delayed Primary Anastomosis in the Management of Long-Gap Esophageal Atresia

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Abstract

In newborns with long-gap esophageal atresia, the esophageal segments are too far apart to allow primary anastomosis. Spontaneous growth and hypertrophy of the two esophageal segments occur at a rate faster than overall somatic growth in the absence of any form of mechanical stretching. The maximal natural growth arises in the first 8–12 weeks of life. The stimuli are the swallowing reflex and the reflux of gastric contents into the lower esophageal pouch. Therefore, initial gastrostomy and continuous suction of the upper esophageal pouch followed by delayed primary anastomosis is an ideal procedure for the management of newborns with long-gap esophageal atresia and provides good long-term functional results.

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Author information

Authors and Affiliations

  1. National Children’s Research Centre, Our Lady’s Children’s Hospital, Crumlin, Dublin 12, Ireland

    Prem Puri & Florian Friedmacher MD, MSc

Authors
  1. Prem Puri
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  2. Florian Friedmacher MD, MSc
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Corresponding author

Correspondence to Prem Puri .

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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Puri, P., Friedmacher, F. (2017). Delayed Primary Anastomosis in the Management of Long-Gap Esophageal Atresia. 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_21

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  • DOI: https://doi.org/10.1007/978-3-642-11202-7_21

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