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. 2015 Oct;31(10):937-42.
doi: 10.1007/s00383-015-3772-2. Epub 2015 Aug 15.

Impact of an external lengthening procedure on the outcome of long-gap esophageal atresia at our hospitals

Kyoko Mochizuki  1 , Masato Shinkai  2 , Hiroshi Take  2 , Norihiko Kitagawa  2 , Hidehito Usui  2 , Hisayuki Miyagi  2 , Kaori Nakamura  2 , Masayuki Obatake  3
Affiliations

Impact of an external lengthening procedure on the outcome of long-gap esophageal atresia at our hospitals

Kyoko Mochizuki et al. Pediatr Surg Int. 2015 Oct.

Abstract

Purpose: To demonstrate the outcome of external lengthening for long-gap esophageal atresia (LGEA) at our hospitals.

Methods: Five patients with LGEA underwent external lengthening between 2010 and 2014 (group A), and 11 patients with LGEA underwent other lengthening techniques between 1990 and 2011 (group B). We compared the procedure and outcome between these two groups.

Results: The mean birth weight was 2001 g in group A and 2485 g in group B (p = 0.06). The mean age at esophageal reconstruction was 28 days in group A and 227 days in group B (p = 0.03). Although primary esophageal anastomosis without myotomy was feasible in all patients in group A, a myotomy was needed for primary esophageal anastomosis in half of the patients in group B. Anastomotic leakage occurred in none in group A and in six patients in group B (p = 0.03). The mean age at the establishment of full oral feeding was 76 days in group A and 686 days in group B (p = 0.009).

Conclusion: External traction for LGEA can effectively lengthen the esophagus to enable primary anastomosis at an earlier age. This may facilitate oral intake.

Keywords: Children; Esophageal atresia; Esophageal lengthening; External traction; Long gap.

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