The elongation of distal esophageal pouch by mechanical bougienage for a year resulted in a tension-free anastomosis in a patient with long gap esophageal atresia: a case report.
Despite the numerous approaches described for the management of neonates with "long gap" esophageal atresia, controversy still exists as to the preferred method. Delayed primary anastomosis is probably the most frequently adopted practice but often the native esophagus is abandoned. We report a case of a 2.98 kg newborn with pure esophageal atresia. Although the elongation of the distal esophageal pouch by mechanical bougienage was initiated at 1 year and 8 months, a successful tension-free anastomosis with minimum dissection of the lower esophagus was performed at 2 years and 7 months. Her postoperative quality of life has been quite excellent. This report emphasizes that a tension-free anastomosis without operating on the lower esophagus and stomach is essential for the treatment of long-gap esophageal atresia.
Hikida
Shigeki
S
Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0031, Japan. shikida@med.kurume-u.ac.jp
Tanaka
Yoshiaki
Y
Tsuru
Tomomitsu
T
Akiyoshi
Kenjiro
K
Asagiri
Kimio
K
Nakamizo
Hirotaka
H
Soejima
Hiroko
H
Ohtani
Mari
M
Fukahori
Suguru
S
Kobayashi
Hidefumi
H
Kaida
Akiko
A
Asagawa
Takahiro
T
Mizote
Hiroyoshi
H
D000714:Anastomosis, Surgical; D002675:Child, Preschool; D004106:Dilatation / Q000379:methods; D004933:Esophageal Atresia / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D013997:Time Factors