title: Repair of esophageal atresia with proximal fistula using endoscopic magnetic compression anastomosis (magnamosis) after staged lengthening.
abstract: We describe the treatment of a patient with long-gap esophageal atresia with an upper pouch fistula, mircogastria and minimal distal esophageal remnant. After 4.5 months of feeding via gastrostomy, a proximal fistula was identified by bronchoscopy and a thoracoscopic modified Foker procedure was performed reducing the gap from approximately 7-5 cm over 2 weeks of traction. A second stage to ligate the fistula and suture approximate the proximal and distal esophagus resulted in a gap of 1.5 cm. IRB and FDA approval was then obtained for endoscopic placement of 10-French catheter mounted magnets in the proximal and distal pouches promoting a magnetic compression anastomosis (magnamosis). Magnetic coupling occurred at 4 days and after magnet removal at 13 days an esophagram demonstrated a 10 French channel without leak. Serial endoscopic balloon dilation has allowed drainage of swallowed secretions as the baby learns bottling behavior at home.
authors.affiliation: Department of Pediatric Surgery, Women and Children's Hospital of Buffalo, 219 Bryant Street, Buffalo, NY, 14222, USA. rmdorman@buffalo.edu.|Department of Surgery, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 14203, USA. rmdorman@buffalo.edu.
authors.forename: Robert M
authors.identifier: http://orcid.org/0000-0002-5528-9484
authors.initials: RM
authors.lastname: Dorman
authors.affiliation: Department of Pediatric Surgery, Women and Children's Hospital of Buffalo, 219 Bryant Street, Buffalo, NY, 14222, USA.|Department of Surgery, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 14203, USA.
authors.forename: Kaveh
authors.initials: K
authors.lastname: Vali
authors.affiliation: Department of Pediatric Surgery, Women and Children's Hospital of Buffalo, 219 Bryant Street, Buffalo, NY, 14222, USA.|Department of Surgery, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 14203, USA.
authors.forename: Carroll M
authors.initials: CM
authors.lastname: Harmon
authors.affiliation: Department of Radiology, The University of Chicago Medicine, Comer Children's Hospital, 5721 S. Maryland Avenue, Chicago, IL, 60637, USA.
authors.forename: Mario
authors.initials: M
authors.lastname: Zaritzky
authors.affiliation: Department of Pediatric Surgery, Women and Children's Hospital of Buffalo, 219 Bryant Street, Buffalo, NY, 14222, USA.|Department of Surgery, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 14203, USA.
authors.forename: Kathryn D
authors.initials: KD
authors.lastname: Bass
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D004933:Esophageal Atresia / Q000601:surgery*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008280:Magnetics; D013272:Stomach Diseases / Q000151:congenital / Q000601:surgery*; D014138:Tracheoesophageal Fistula / Q000601:surgery*
keywords: Endoscopy; Esophageal atresia; Magnamosis; Magnetic compression anastomosis; Tracheoesophageal fistula