Magnetic compression anastomosis as a nonsurgical treatment for esophageal atresia.
BACKGROUND
We describe a unique technique to promote a nonsurgical esophageal anastomosis with magnets in children with esophageal atresia.


OBJECTIVE
To evaluate the efficacy of magnetic lengthening of atretic esophageal ends to produce an anastomosis and to communicate our results after more than 2 years of follow-up.


METHODS
Between September 2001 and March 2004, five children were selected for treatment. Two of the children had esophageal atresia without fistula (type A) and three had atresia with fistula converted to type A surgically; however, surgeons failed to achieve an anastomosis because of the width of the gap. Neodymium-iron-boron magnets were used. Daily chest radiographs were taken until union of the magnets was observed. They were then replaced with an orogastric tube.


RESULTS
Anastomosis was achieved in all patients in an average of 4.8 days. One patient, with signs of early sepsis, was successfully treated with antibiotics. In four of the five patients, esophageal stenosis developed. At the time of this report, two patients were free of treatment and on an oral diet (after 26 months), two patients required periodic balloon dilatation, and one patient had recently undergone surgery due to recurrent esophageal stenosis not amenable to balloon dilatation.


CONCLUSIONS
Magnetic esophageal anastomosis is a feasible method in selected patients with esophageal atresia. Esophageal anastomosis was achieved in all patients. The only observed complication of significance was esophageal stenosis. One patient needed surgery because of stenosis.
Zaritzky
Mario
M
Department of Radiology, Hospital de Niños de La Plata, Buenos Aires, Argentina. mzaritzky@radiology.bsd.uchicago.edu
Ben
Ricardo
R
Zylberg
Gaston I
GI
Yampolsky
Brian
B
D000714:Anastomosis, Surgical; D002648:Child; D004867:Equipment Design; D019544:Equipment Failure Analysis; D004933:Esophageal Atresia / Q000628:therapy*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D008280:Magnetics / Q000295:instrumentation*; D008297:Male; D016896:Treatment Outcome