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Position Paper of INoEA Working Group on Long-Gap Esophageal Atresia: For Better Care
INoEA is the International Network of Esophageal Atresia and consists of a broad spectrum of pediatric specialties and patient societies. The working group on long-gap esophageal atresia (LGEA) set out to develop guidelines regarding the definition of LGEA, the best diagnostic and treatment strategi...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5374143/ https://www.ncbi.nlm.nih.gov/pubmed/28409148 http://dx.doi.org/10.3389/fped.2017.00063 |
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author | van der Zee, David C. Bagolan, Pietro Faure, Christophe Gottrand, Frederic Jennings, Russell Laberge, Jean-Martin Martinez Ferro, Marcela Hernan Parmentier, Benoît Sfeir, Rony Teague, Warwick |
author_facet | van der Zee, David C. Bagolan, Pietro Faure, Christophe Gottrand, Frederic Jennings, Russell Laberge, Jean-Martin Martinez Ferro, Marcela Hernan Parmentier, Benoît Sfeir, Rony Teague, Warwick |
author_sort | van der Zee, David C. |
collection | PubMed |
description | INoEA is the International Network of Esophageal Atresia and consists of a broad spectrum of pediatric specialties and patient societies. The working group on long-gap esophageal atresia (LGEA) set out to develop guidelines regarding the definition of LGEA, the best diagnostic and treatment strategies, and highlight the necessity of experience and communication in the management of these challenging patients. Review of the literature and expert discussion concluded that LGEA should be defined as any esophageal atresia (EA) that has no intra-abdominal air, realizing that this defines EA with no distal tracheoesophageal fistula (TEF). LGEA is considerably more complex than EA with distal TEFs and should be referred to a center of expertise. The first choice is to preserve the native esophagus and pursue primary repair, delayed primary anastomosis, or traction/growth techniques to achieve anastomosis. A cervical esophagostomy should be avoided if possible. Only if primary anastomosis is not possible, replacement techniques should be used. Jejunal interposition is proposed as the best option among the major EA centers. In light of the infrequent occurrence of LGEA and the technically demanding techniques involved to achieve esophageal continuity, it is strongly advised to develop regional or national centers of expertise for the management and follow-up of these very complex patients. |
format | Online Article Text |
id | pubmed-5374143 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-53741432017-04-13 Position Paper of INoEA Working Group on Long-Gap Esophageal Atresia: For Better Care van der Zee, David C. Bagolan, Pietro Faure, Christophe Gottrand, Frederic Jennings, Russell Laberge, Jean-Martin Martinez Ferro, Marcela Hernan Parmentier, Benoît Sfeir, Rony Teague, Warwick Front Pediatr Pediatrics INoEA is the International Network of Esophageal Atresia and consists of a broad spectrum of pediatric specialties and patient societies. The working group on long-gap esophageal atresia (LGEA) set out to develop guidelines regarding the definition of LGEA, the best diagnostic and treatment strategies, and highlight the necessity of experience and communication in the management of these challenging patients. Review of the literature and expert discussion concluded that LGEA should be defined as any esophageal atresia (EA) that has no intra-abdominal air, realizing that this defines EA with no distal tracheoesophageal fistula (TEF). LGEA is considerably more complex than EA with distal TEFs and should be referred to a center of expertise. The first choice is to preserve the native esophagus and pursue primary repair, delayed primary anastomosis, or traction/growth techniques to achieve anastomosis. A cervical esophagostomy should be avoided if possible. Only if primary anastomosis is not possible, replacement techniques should be used. Jejunal interposition is proposed as the best option among the major EA centers. In light of the infrequent occurrence of LGEA and the technically demanding techniques involved to achieve esophageal continuity, it is strongly advised to develop regional or national centers of expertise for the management and follow-up of these very complex patients. Frontiers Media S.A. 2017-03-31 /pmc/articles/PMC5374143/ /pubmed/28409148 http://dx.doi.org/10.3389/fped.2017.00063 Text en Copyright © 2017 van der Zee, Bagolan, Faure, Gottrand, Jennings, Laberge, Martinez Ferro, Parmentier, Sfeir and Teague. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics van der Zee, David C. Bagolan, Pietro Faure, Christophe Gottrand, Frederic Jennings, Russell Laberge, Jean-Martin Martinez Ferro, Marcela Hernan Parmentier, Benoît Sfeir, Rony Teague, Warwick Position Paper of INoEA Working Group on Long-Gap Esophageal Atresia: For Better Care |
title | Position Paper of INoEA Working Group on Long-Gap Esophageal Atresia: For Better Care |
title_full | Position Paper of INoEA Working Group on Long-Gap Esophageal Atresia: For Better Care |
title_fullStr | Position Paper of INoEA Working Group on Long-Gap Esophageal Atresia: For Better Care |
title_full_unstemmed | Position Paper of INoEA Working Group on Long-Gap Esophageal Atresia: For Better Care |
title_short | Position Paper of INoEA Working Group on Long-Gap Esophageal Atresia: For Better Care |
title_sort | position paper of inoea working group on long-gap esophageal atresia: for better care |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5374143/ https://www.ncbi.nlm.nih.gov/pubmed/28409148 http://dx.doi.org/10.3389/fped.2017.00063 |
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