INoEA 2025 7th International Conference on Esophageal Atresia & 11th International PAAFIS Symposium & Aerodigestive Society Meeting

R Sfeir, P Fayoux, A Maltezeanu, F Gottrand, D Sharma

Lille University Hospital, Lille, France

Long gap esophageal atresia (EA) still a challenge with controversies and heterogeneity in its management. Delayed primary anastomosis still the most used technique with necessity of a gastrostomy and managing the saliva outflow of the upper pouch. A diverting pharyngostomy can be sufficient to assure saliva outflow leading the upper pouch aspiration not necessary and permit the return of the child at home. The aim of this study is to review our experience in long gap EA with this new technique.

Methods:

From May 2013 to December 2023, we performed a pharyngostomy in 8 patients with EA (5 type A, 2 type C, 1 type D, table 1). In the same period this technique was used in 3 patients with caustic injuries 2 patients with recurrent oesotracheal fistula, 1 patient with associated complex laryngeal abnormalities and 1 patient with severe refractory anastomotic stenosis.

Results :

Table 1

V: number of vertebrae, d: days, CR: colonic replacement, DPA: delayed primary anastomosis

Commentaries:

Pharyngostomy, in our experience, allow us to manage the long gap EA cases, without any hurry due to initial long admission. It's main advantage is to preserve the upper pouch from any mobilisation or dissection. Delayed primary anastomosis was succesfull in 3 cases in this series at 289, 423 and 503 days respectively. Colonic replacement was decided when pouch’s growth was absent or insufficient. Closure of the pharyngostomy can be spontaneaous after the esophageal construction.

R Sfeir, P Fayoux, A Maltezeanu, F Gottrand, D Sharma

Lille Üniversite Hastanesi, Lille, France