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An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
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Published on: April 17, 2020

Use of transanastomotic feeding tubes during esophageal atresia repair

Saleh I Alabbad1, Jon Ryckman, Pramod Shailendra Puligandla

  • 1Division of Pediatric Surgery, The Montreal Children's Hospital, Montréal, Québec, Canada. saleh.al-abbad@mail.mcgill.ca

Journal of Pediatric Surgery
|May 13, 2009
PubMed

Insights

Transanastomotic feeding tubes (TAFTs) for esophageal atresia type C may reduce total parenteral nutrition (TPN) duration and cholestasis. Further research is needed to confirm benefits and rule out increased anastomotic leaks.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Neonatal Care

Background:

  • Esophageal atresia with tracheoesophageal fistula (EA/TEF) type C is the most common form, affecting 85% of EA cases.
  • Traditional postoperative care involved total parenteral nutrition (TPN) until contrast esophagography confirmed feeding readiness.

Purpose of the Study:

  • To evaluate the impact of intraoperatively placed transanastomotic feeding tubes (TAFTs) on patient outcomes in EA/TEF type C.

Main Methods:

  • A 7-year retrospective review of 21 patients with EA/TEF type C.
  • Comparison of outcomes between patients with and without TAFTs, including TPN duration, feeding resumption, and complications.

Main Results:

  • No significant differences in demographics, associated anomalies, or operative time between groups.
  • TAFT group showed a trend towards shorter TPN duration (12 vs. 20 days) and less cholestasis (11% vs. 36%) compared to the non-feeding tube (NFT) group.
  • Anastomotic leak rates were 8% for TAFT and 22% for NFT; stenosis rates were 36% for TAFT and 22% for NFT.

Conclusions:

  • TAFTs may offer benefits by shortening TPN duration and reducing cholestasis in EA/TEF type C.
  • Larger prospective studies, potentially through networks like the Canadian Pediatric Surgery Network, are necessary to confirm these findings and assess anastomotic leak risks.
Abstract

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