title: 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.
abstract: 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.
authors.affiliation: Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0031, Japan. shikida@med.kurume-u.ac.jp
authors.forename: Shigeki
authors.initials: S
authors.lastname: Hikida
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Tomomitsu
authors.initials: T
authors.lastname: Tsuru
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Akiyoshi
authors.forename: Kimio
authors.initials: K
authors.lastname: Asagiri
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Nakamizo
authors.forename: Hiroko
authors.initials: H
authors.lastname: Soejima
authors.forename: Mari
authors.initials: M
authors.lastname: Ohtani
authors.forename: Suguru
authors.initials: S
authors.lastname: Fukahori
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Akiko
authors.initials: A
authors.lastname: Kaida
authors.forename: Takahiro
authors.initials: T
authors.lastname: Asagawa
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Mizote
mesh_terms: 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