The novel application of an emerging device for salvage of primary repair in high-risk complex esophageal atresia

Evans, Lauren L.; Chen, Caressa S.; Muensterer, Oliver J.; Sahlabadi, Mohammad; Lovvorn, Harold N.; Novotny, Nathan M.; Upperman, Jeffrey S.; Martinez, J. Andres; Bruzoni, Matias; Dunn, James C. Y.; Harrison, Michael R.; Fuchs, Julie R. und Zamora, Irving J. (2022): The novel application of an emerging device for salvage of primary repair in high-risk complex esophageal atresia. In: Journal of Pediatric Surgery, Bd. 57, Nr. 12: S. 810-818

Abstract

Introduction: Preservation of native esophagus is a tenet of esophageal atresia (EA) repair. However, tech-niques for delayed primary anastomosis are severely limited for surgically and medically complex pa-tients 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 endo-scopic 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 com-plex 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.(c) 2022 Elsevier Inc. All rights reserved.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0022-3468
• Sprache: Englisch