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REVIEW article

Front. Pediatr.
Sec. Pediatric Surgery
Volume 12 - 2024 | doi: 10.3389/fped.2024.1450378

Long-Gap Esophageal Atresia: is native esophagus preservation always possible?

Provisionally accepted
Giuliana M. Treccarichi Giuliana M. Treccarichi 1Vincenzo Di Benedetto Vincenzo Di Benedetto 1Giada Loria Giada Loria 1,2*Maria Grazia Scuderi Maria Grazia Scuderi 1
  • 1 Division of Pediatric Surgery, Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, University of Catania, Catania, Sicily, Italy
  • 2 Unit of Pathology, Department of Human Pathology in Adulthood and Childhood Gaetano Barresi, University of Messina, Messina, Sicily, Italy

The final, formatted version of the article will be published soon.

    Introduction: Esophageal atresia (EA) is a congenital defect that causes esophageal discontinuity, often with an associated tracheo-esophageal fistula (TEF) in 70-90% of cases. When the distance between esophageal ends precludes primary anastomosis, it results in long gap esophageal atresia (LGEA), complicating the surgical management. This study retrospectively reviewed LGEA cases from the past decade, treated with the goal of preserving the native esophagus, comparing surgical techniques and outcomes with current literature.The data of patients treated for LGEA between 2013 and 2024 were collected from medical charts, focusing on patients treated with the preservation of their native esophagus. Results: Ten patients were enrolled for this study. All of them had a gap between the esophageal ends equal to or greater than three vertebral bodies. Four patients (40%) underwent a delayed primary anastomosis (DPA) procedure, while the remaining six (60%) underwent a traction staged repair. All patients were treated with open surgery. The follow-up period extended from 3 months to 10 years.LGEA is a challenging but feasible goal, with delayed primary anastomosis and traction techniques playing key roles. We advocate for the preservation of the native esophagus as the preferred approach for ensuring a high quality of life for patients, as it helps to avoid severe long-term complications associated with esophageal substitution.

    Keywords: Esophageal Atresia, Long gap esophageal atresia, Esophageal replacement, esophageal repair, Esophageal salvage, Anastomotic stricture, Gastroesophageal Reflux

    Received: 17 Jun 2024; Accepted: 12 Aug 2024.

    Copyright: © 2024 Treccarichi, Di Benedetto, Loria and Scuderi. 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.

    * Correspondence: Giada Loria, Division of Pediatric Surgery, Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, University of Catania, Catania, Sicily, Italy

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.