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An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
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Esophageal Atresia and Upper Airway Pathology

David C van der Zee1, Maud Y A van Herwaarden1, Caroline C C Hulsker1

  • 1Department of Pediatric Surgery, University Medical Center Utrecht, KE. 04.140.5, PO Box 85090, Utrecht 3508 AB, The Netherlands.

Clinics in Perinatology
|November 13, 2017
PubMed

Insights

Esophageal atresia requires lifelong management due to complex sequelae. Advanced thoracoscopic surgery for concurrent tracheomalacia offers quicker recovery than traditional open procedures.

Area of Science:

  • Pediatric Surgery
  • Thoracic Surgery
  • Congenital Anomalies

Background:

  • Esophageal atresia (EA) presents complex lifelong management challenges.
  • Concurrent tracheomalacia is a common, potentially life-threatening EA complication.
  • Traditional aortopexy for tracheomalacia required invasive thoracotomies.

Purpose of the Study:

  • To highlight the importance of specialized centers for EA management.
  • To discuss the advancements in surgical treatment for EA-associated tracheomalacia.
  • To compare thoracoscopic versus open surgical approaches.

Main Methods:

  • Review of current management strategies for EA and tracheomalacia.
  • Description of thoracoscopic aortopexy and posterior tracheopexy techniques.
  • Comparison of recovery outcomes between surgical methods.

Main Results:

  • Specialized centers are crucial for comprehensive EA care.
  • Thoracoscopic aortopexy and tracheopexy enable minimally invasive treatment.
  • Thoracoscopic procedures result in faster patient recovery.

Conclusions:

  • Optimal management of esophageal atresia necessitates expert centers.
  • Minimally invasive thoracoscopic surgery significantly improves outcomes for associated tracheomalacia.
  • Advancements in surgical techniques offer improved recovery for EA patients.

Keywords:
Esophageal atresiaEsophageal stenosisGastroesophageal reflux diseaseLong gap esophageal atresiaRecurrent fistulaTracheoesophageal fistulaTracheomalacia

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