Long-gap esophageal atresia: management, most frequent complications, and expert recommendations – review of literature

KĘDZIERSKA, Zofia, DADAS, Klaudia, ŻUREK, Urszula, TOŁWIŃSKI, Ignacy, ŚWIERCZ, Aleksandra, MAŁACHOWSKA, Dominika, CIECIERSKI-KOŹLAREK, Hubert, ANTKOWIAK, Klaudia and SHVED, Kateryna. Long-gap esophageal atresia: management, most frequent complications, and expert recommendations – review of literature. Journal of Education, Health and Sport. 2023;45(1):310-326. eISSN 2391-8306. https://dx.doi.org/10.12775/JEHS.2023.45.01.022

https://apcz.umk.pl/JEHS/article/view/45351

https://zenodo.org/record/8280189

 

 

 

 

 

The journal has had 40 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of 17.07.2023 No. 32318. Has a Journal's Unique Identifier: 201159. Scientific disciplines assigned: Physical Culture Sciences (Field of Medical sciences and health sciences); Health Sciences (Field of Medical Sciences and Health Sciences).

Punkty Ministerialne z 2019 - aktualny rok 40 punktów. Załącznik do komunikatu Ministra Edukacji i Nauki z dnia 17.07.2023 Lp. 32318. Posiada Unikatowy Identyfikator Czasopisma: 201159.

Przypisane dyscypliny naukowe: Nauki o kulturze fizycznej (Dziedzina nauk medycznych i nauk o zdrowiu); Nauki o zdrowiu (Dziedzina nauk medycznych i nauk o zdrowiu).

© The Authors 2023;

This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland

Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike.

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The authors declare that there is no conflict of interests regarding the publication of this paper.

Received: 26.07.2023. Revised:21.08.2023. Accepted: 24.08.2023. Published: 29.08.2023.

 

 

 

 

 

Long-gap esophageal atresia: management, most frequent complications, and expert recommendations – review of literature

 

Zofia Kędzierska

Warszawski Szpital Południowy, ul. rtm. Witolda Pileckiego 99, 02-781 Warszawa, Poland ORCiD: 0000-0002-4181-4719
e-mail: zo.kedzierska@gmail.com 

 

Klaudia Dadas

Warszawski Szpital Południowy, ul. rtm. Witolda Pileckiego 99, 02-781 Warszawa, Poland ORCiD: 0009-0007-3352-9807
e-mail: klaudia.w.2703@gmail.com 

 

Urszula Żurek
Warszawski Szpital Południowy, ul. rtm. Witolda Pileckiego 99, 02-781 Warszawa, Poland ORCiD: 0009-0008-3482-5381

e-mail: ula.zurek@gmail.com 

 

Ignacy Tołwiński

Warszawski Szpital Południowy, ul. rtm. Witolda Pileckiego 99, 02-781 Warszawa, Poland ORCiD: 0000-0003-1362-6734
e-mail: ignacyt233@gmail.com 

 

 

Aleksandra Świercz

Warszawski Szpital Południowy, ul. rtm. Witolda Pileckiego 99, 02-781 Warszawa, Poland ORCiD: 0009-0007-1535-1590
e-mail: aleksandra.swiercz1996@gmail.com 

 

Dominika Małachowska

Warszawski Szpital Południowy, ul. rtm. Witolda Pileckiego 99, 02-781 Warszawa, Poland ORCiD: 0009-0008-6305-7959
e-mail: dominika1.malachowska@gmail.com 

 

Hubert Ciecierski-Koźlarek

Wojewódzki Szpital Specjalistyczny w Olsztynie, ul. Żołnierska 18, 10-561 Olsztyn, Poland ORCiD: 0009-0009-4062-6888
e-mail: hubertciecierski@icloud.com 

 

Klaudia Antkowiak

Szpital Średzki Serca Jezusowego sp. z o.o. ul. Żwirki i Wigury 10, 63-000 Środa Wielkopolska, Poland
ORCiD: 0009-0008-3421-2200
e-mail: klaudia.antkowiak2021@gmail.com

 

Kateryna Shved

Wielospecjalistyczny Szpital Miejski im. Józefa Strusia, ul. Szwajcarska 3, 61-285 Poznań, Poland
ORCiD: 0009-0002-3773-7025
e-mail: katey.shved@gmail.com 

 

Abstract

 

Introduction and aim of the study. Long-gap esophageal atresia (LGEA) is a congenital anomaly in which the gap between both ends of the esophagus exceeds three intervertebral spaces and is an esophageal atresia without air in the abdomen. The defect is both therapeutic and surgical challenge. This review aims at providing an overview of the most recent literature on the effective methods for treatment of LGEA, and the most frequent complications and experts’ recommendations on this subject.

Material and methods. The systematic review was based on available data collected using PubMed database and the Google Scholar web search engine.

Analysis of the literature. There is no consensus on the ideal technique for surgical treatment of LGEA. There are two possible approaches for opening the thorax – thoracotomy and thoracoscopy. The techniques stimulating esophageal elongation include external and internal traction techniques, magnetic compression anastomosis and intramural botulinum type A toxin injection. Replacement methods are a viable option when it is impossible to preserve the native esophagus. Decellularized matrices seem to be promising in developing an esophageal substitute. Regardless of the surgical approach a common complication of surgical treatment is anastomotic stenosis which requires further surgical interventions.

Conclusion. Elongation techniques are effective in approximation of the proximal and distal esophagus. The future lies with tissue engineering and inventing an off-the-shelf esophageal substitute. The centralization of treatment is recommended. After discharge from hospital interdisciplinary outpatient assessment and care is required. Further prospective studies are needed to determine the optimal mode of treatment and prevent complications associated with LGEA.

 

Keywords: esophageal atresia, long gap, surgical management, delayed primary anastomosis, anastomotic strictures