The novel application of an emerging device for salvage of primary repair in high-risk complex esophageal atresia.
J Pediatr Surg
; 57(12): 810-818, 2022 Dec.
Article
in En
| MEDLINE
| ID: mdl-35760639
ABSTRACT
INTRODUCTION:
Preservation of native esophagus is a tenet of esophageal atresia (EA) repair. However, techniques for delayed primary anastomosis are severely limited for surgically and medically complex patients at high-risk for operative repair. We report our initial experience with the novel application of the Connect-EA, an esophageal magnetic compression anastomosis device, for salvage of primary repair in 2 high-risk complex EA patients. Compassionate use was approved by the FDA and treating institutions. OPERATIVE TECHNIQUE Two approaches using the Connect-EA are described - a totally endoscopic approach and a novel hybrid operative approach. To our knowledge, this is the first successful use of a hybrid operative approach with an esophageal magnetic compression device.OUTCOMES:
Salvage of delayed primary anastomosis was successful in both patients. The totally endoscopic approach significantly reduced operative time and avoided repeat high-risk operation. The hybrid operative approach salvaged delayed primary anastomosis and avoided cervical esophagostomy.CONCLUSION:
The Connect-EA is a novel intervention to achieve delayed primary esophageal repair in complex EA patients with high-risk tissue characteristics and multi-system comorbidities that limit operative repair. We propose a clinical algorithm for use of the totally endoscopic approach and hybrid operative approach for use of the Connect-EA in high-risk complex EA patients.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tracheoesophageal Fistula
/
Esophageal Atresia
/
Esophagoplasty
Type of study:
Etiology_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
J Pediatr Surg
Year:
2022
Document type:
Article