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An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
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Image-guided esophageal anastomosis in esophageal atresia

Alejandro V Garcia1, Arul S Thirumoorthi, Jocelyn M Traina

  • 1Division of Pediatric Surgery, Department of Surgery, Morgan Stanley Children's Hospital, CHN 204, New York, NY 10032, USA. alg2025@columbia.edu

Journal of Pediatric Surgery
|October 23, 2012
PubMed

Insights

Infants with tracheoesophageal fistulas and cardiac issues pose surgical challenges. An image-guided esophageal anastomosis technique offered a solution for a high-risk infant, establishing esophageal continuity.

Area of Science:

  • Pediatric Surgery
  • Cardiology
  • Gastroenterology

Background:

  • Tracheoesophageal fistulas (TEF) and esophageal atresia (EA) often coexist with complex congenital heart disease.
  • Cardiac instability during surgical repair can preclude primary esophageal anastomosis.

Observation:

  • A case is presented of an infant with EA and cardiac disease who experienced hemodynamic compromise during attempted primary esophageal anastomosis.
  • The initial surgical attempt involved approximating esophageal segments but was halted due to cardiac instability.

Findings:

  • A novel, image-guided technique was employed postoperatively to achieve esophageal anastomosis.
  • The anastomosis was successfully completed and followed by esophageal dilation.

Implications:

  • This image-guided approach offers a viable alternative for establishing esophageal continuity in high-risk infants.
  • It may improve outcomes for neonates with TEF/EA and complex cardiac conditions who are poor candidates for immediate primary repair.

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