Abstract
Pure esophageal atresia (EA) constitutes 5–7 % of all esophageal atresias. Isolated EA lacks a tracheoesophageal fistula (TEF) and is characterized by a long distance between the esophageal pouches that often precludes primary anastomosis. We propose a treatment algorithm that incorporates the many anatomical factors affecting the timing and technical approach to esophageal reconstruction. We describe thoracoscopic techniques for esophageal lengthening and reconstruction including delayed primary anastomosis, intrathoracic esophageal elongation, extrathoracic esophageal elongation, and esophageal replacement. Using this algorithm, 80 % of EA can be reconstructed thoracoscopically using the native esophagus with excellent functional outcome.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Martinez-Ferro M, Cannizaro C, Rodriguez S, Rabasa C, editors. Neonatología quirúrgica. Grupo Guía S.A.: Ciudad Autónoma de Buenos Aires; 2004.
Ohno K, Nakamura T, Azuma T, et al. Esophageal atresia with tracheoesophageal fistula in both members of monozygotic twins. Pediatr Surg Int. 2008;24(10):1137–9.
Brown AK, Roddam AW, Spitz L, Ward SJ. Esophageal atresia, related malformations, and medical problems: a family study. Am J Med Genet. 1999;85(1):31–7.
Al-Shanafey S, Harvey J. Long gap esophageal atresia: an Australian experience. J Pediatr Surg. 2008;43(4):597–601.
Ron O, De Coppi P, Pierro A. The surgical approach to esophageal atresia repair and the management of long-gap atresia: results of a survey. Semin Pediatr Surg. 2009;18(1):44–9.
Marcelo M-F. Thoracoscopic repair of esophageal atresia without fistula. In: Bax KMA, Georgeson KE, Rothenberg SS, editors. Endoscopic surgery in infants and children. New York: Springer; 2008. p. 206–19.
Martinez-Ferro M. Thoracoscopic repair of esophageal atresia without tracheoesophageal fistula. In: Holcomb GW, Georgeson KE, Rothenberg SS, editors. Atlas of pediatric laparoscopy and thoracoscopy. Philadelphia: Saunders Elsevier; 2008. p. 291–6.
Martinez-Ferro M. International guest lecture: new approaches to pectus and other minimally invasive surgery in Argentina. J Pediatr Surg. 2010;45:19–27.
Esteves E, Silva MC, Paiva KC, et al. Laparoscopic gastric pull-up for long gap esophageal atresia. J Laparoendosc Adv Surg Tech A. 2009;19:S191–5.
Holcomb III GW. Identification of the distal esophageal segment during delayed repair of esophageal atresia and tracheoesophageal fistula. Surg Gynecol Obstetrics. 1992;174:323–4.
Shah R, Neto PN. An innovative technique for reusable laparoscopic cannula stabilization and fixation. Pediatr Endosurg Innsov Tech. 1997;1:59–61.
Rehbein F, Schweder N. Reconstruction of the esophagus without colon transplantation in cases of atresia. J Pediatr Surg. 1971;6:746–52.
Lee H, Farmer D, Albanese C, et al. Traction elongation for treatment of long-gap esophageal atresia. Pediatr Endosurg Innov Tech. 2002;6:51–4.
Kimura K, Soper RT. Multistaged extrathoracic esophageal elongation for long gap esophageal atresia. J Pediatr Surg. 1994;29:566–8.
Kimura K, Nishijima E, Tsugawa C, et al. Multistaged extrathoracic esophageal elongation procedure for long gap esophageal atresia: experience with 12 patients. J Pediatr Surg. 2001;36(11):1725–7.
Takamizawa S, Nishijima E, Tsugawa C, et al. Multistaged esophageal elongation technique for long gap esophageal atresia: experience with 7 cases at a single institution. J Pediatr Surg. 2005;40(5):781–4.
Tamburri N, Laje P, Boglione M, Martinez-Ferro M. Extrathoracic esophageal elongation (Kimura’s technique): a feasible option for the treatment of patients with complex esophageal atresia. J Pediatr Surg. 2009;44:2420–5.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Padilla, B.E., Martinez-Ferro, M. (2017). Thoracoscopic Repair of Pure 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_23
Download citation
DOI: https://doi.org/10.1007/978-3-642-11202-7_23
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-11201-0
Online ISBN: 978-3-642-11202-7
eBook Packages: MedicineMedicine (R0)