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Updated: Aug 11, 2026

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
Type IV laryngotracheoesophageal clefts: surgical management for long-term survival
B B Simpson1, D P Ryan, P K Donahoe
1Department of Pediatric Surgery, Massachusetts General Hospital, Boston 02114, USA.
Abstract:
Complete laryngotracheoesophageal clefts (types III and IV) are rare congenital anomalies that occur when the primitive foregut fails to separate into the tracheobronchial tree and the esophagus. This article summarizes a 10-year institutional experience with six infants who had type IV clefts, presents a modification of the authors' surgical approach, and identifies pitfalls in the management of these infants. Three of the six children are long-term survivors. The recognition of specific complicating issues leads to a standardized approach, which can result in successful repair and long-term survival.
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