Efficacy of a standardized tube weaning program in pediatric patients with feeding difficulties after successful repair of their esophageal atresia/tracheoesophageal fistula
Conclusions: The study ’s findings support the efficacy of tube weaning based on the published “Graz model of tube weaning” for children born with EA/TEF and indicate the necessity of specialized tube weaning programs for these patients.What is Known:• Children with esophageal atresia/tracheoesophageal fistula often suffer from feeding problems and tube dependency.• Different tube weaning programs and outcomes have been published, but not specifically for children with EA.What is New:• Evaluation of a large sample of children referred for tube weaning after EA repair.• Most children with EA can be weaned off their feeding tubes successfully after attending a specialized tube weaning program.
Publication date: Available online 21 September 2020Source: Journal of Pediatric Surgery Case ReportsAuthor(s): E. Bindi, G. Torino, C. Noviello, A. Simonini, M. Torre, R. D'Agostino, G. Cobellis
AbstractThe current study was aimed to define clinical practice, knowledge and awareness, and best practice regarding dysphagia in children with esophageal atresia with/without tracheoesophageal fistula (EA-TEF) from the perspective of pediatric surgeons in Turkey. Pediatric surgeons practice EA repair were included. A survey related to clinical practice, knowledge and awareness, and best practice regarding dysphagia in EA-TEF was used. The survey was electronically sent to potential participants. Seventy-two pediatric surgeons with a mean professional experience of 14.73 ± 9.66 years (min&thinsp...
We present the use of a viable omental flap and complete esophageal mobilization to prevent subsequent TEF recurrences and avoid the additional morbidity of reconstructive surgery. PMID: 32804549 [PubMed - as supplied by publisher]
Conclusions: Thoracoscopic “primary” repair of type-C esophageal atresia is feasible in premature/term neonates with a 1:10 conversion rate. Around one third surgeons prefer azygous sparing approach and three fourth placement of chest tubes, but there is no unanimity on the fistula ligation technique. The procedure has morbidity in one fourth patients and 5% mortality.
Conclusion: The incidence of postoperative GERD and esophageal stricture was 67.2% and 37.9%, respectively. The risk factors for postoperative esophageal stricture were long-gap EA/TEF and postoperative GERD.What is Known:•EA/TEF is a congenital digestive tract anomaly with a high postoperative survival rate but can be complicated by many long-term morbidities.What is New:•Long-gap EA/TEF and postoperative GERD are risk factors of anastomotic stricture after repair.•Surgeons and pediatricians should be highly experienced in managing anastomotic tension and the GERD.
Thoracoscopic repair of esophageal atresia with tracheoesophageal fistula (EA/TEF) remains technically challenging due to the rarity of these procedures. The aim of this study is to report our experience with thoracoscopic repair of type C EA/TEF and to evaluate the learning curve based upon the surgeon's skill level.
In conclusion, the reported prevalence of scoliosis varies widely but on average affects about one in eight children after open repair of EA/TEF. Most cases are mild and do not require intervention. It is currently uncertain whether secondary scoliosis is preventable by using meticulous thoracotomy techniques or thoracoscopic repair.Level of evidence IV.
CONCLUSIONS: Surgical outcomes for repair of OA/TOF are not adversely affected by trainee operating. Trainees with appropriate skills should perform supervised OA/TOF repair. These data are important for understanding the interrelationship between provision of training and surgical outcomes. PMID: 32436786 [PubMed - as supplied by publisher]
AbstractPurposeIntraoperative chest tubes (IOCTs) can be placed during esophageal atresia/tracheoesophageal fistula (EA/TEF) repair to control pneumothoraces and detect esophageal leaks, potentially preventing the need for postoperative chest tubes (POCTs). However, data are lacking regarding IOCTs ’ effect. We hypothesized that IOCT placement would not reduce the risk of POCT placement and would increase hospital length of stay (LOS).MethodsThis was a single-center case-control study of type C EA/TEF patients repaired at a tertiary referral center between 2006 and 2017. Postoperative complications of patients who re...
Publication date: Available online 15 April 2020Source: Journal of Pediatric Surgery Case ReportsAuthor(s): Takeshi Saito, Hidemi Suzuki, Takahiro Nakajima, Yuichi Sakairi, Keita Terui, Mitsuyuki Nakata, Shugo Komatsu, Ichiro Yoshino, Tomoro Hishiki