Transplant delay will reduce anastomotic complications of gastric pull up for isolated esophageal atresia

Anastomotic dehiscence is a major source of mortality after gastric pull up reconstruction for isolated esophageal atresia. Inadequate blood supply is a leading etiologic factor for dehiscence. To enhance vascularity of the stomach, and thereby reduce anastomotic complications, laparoscopic partial gastric devascularization 14 days prior to gastric pull up is proposed. The reconstructive principle of skin flap delay is applied to the gastric pull up procedure.