EN
TÜRKÇE
Poster - 53
Method of Internal traction in the management long gap esophageal atresia: our experience
A Podkamenev, R Ti, S Kuzminykh, V Dvoreckiy, A Syrtsova, O Murashova
Saint-Petersburg State Pediatric Medical University
Esophageal atresia (EA) with a long gap is the most severe form of this malformation. A considerable number of esophageal elongation techniques have been proposed, but in our opinion, the most promising and effective is the technique proposed in 2015 by Dariusz Patkowski.
Method: Analysis of efficiency of thoracoscopic internal traction in long gap EA.
Results: From 2021 to 2024 Internal traction was performed in 8 children.
The average gestational age was 36 1/7 weeks (29 5/7 – 38 4/7) and birth weight was 2095 g (1200–2820). They were 5 children with EA type A by Gross and 3 children with type C. In all children, the gap of 6 and more vertebral bodies was determined intraoperatively. The age at the start of treatment was 23 days (6–90). The first stage of treatment consisted of 2 elongations with 3-5 days between them for type A and 1 elongation for type C. Anastomosis was performed 3-5 days after the last elongation. The average duration of the operation was 117 minutes (45-210). In all cases staged repair and direct anastomosis were performed.
Postoperative complications occurred in 5 of 8 patients. Anastomotic leakage was detected in one case. Two children died at a period of more than 2 months after the operation from causes not related to the postoperative course of this disease (assotiated malformations). In one case developed gastroesophageal reflux requiring surgical correction. One patient required staged balloon dilation of the esophagus, with further observation without signs of recurrence. In three cases, we did not observe any complications.
Conclusion: In our experience the method of internal traction of the esophagus with subsequent formation of anastomosis is effective in children with long gap EA and allows in most cases to preserve the native esophagus.