ERNICA Consensus Conference on the Management of Patients with Long-Gap Esophageal Atresia: Perioperative, Surgical, and Long-Term Management

Carmen Dingemann, Simon Eaton, Gunnar Aksnes, Pietro Bagolan, Kate M Cross, Paolo De Coppi, JoAnne Fruithof, Piergiorgio Gamba, Imeke Goldschmidt, Frederic Gottrand, Sabine Pirr, Lars Rasmussen, Rony Sfeir, Graham Slater, Janne Suominen, Jan F Svensson, Joergen M Thorup, Stefaan H A J Tytgat, David C van der Zee, Lucas WesselAnke Widenmann-Grolig, René Wijnen, Wilhelm Zetterquist, Benno M Ure

    35 Citationer (Scopus)

    Abstract

    INTRODUCTION:  Evidence supporting best practice for long-gap esophageal atresia is limited. The European Reference Network for Rare Inherited Congenital Anomalies (ERNICA) organized a consensus conference on the management of patients with long-gap esophageal atresia based on expert opinion referring to the latest literature aiming to provide clear and uniform statements in this respect.

    MATERIALS AND METHODS:  Twenty-four ERNICA representatives from nine European countries participated. The conference was prepared by item generation, item prioritization by online survey, formulation of a final list containing items on perioperative, surgical, and long-term management, and literature review. The 2-day conference was held in Berlin in November 2019. Anonymous voting was conducted via an internet-based system using a 1 to 9 scale. Consensus was defined as ≥75% of those voting scoring 6 to 9.

    RESULTS:  Ninety-seven items were generated. Complete consensus (100%) was achieved on 56 items (58%), e.g., avoidance of a cervical esophagostomy, promotion of sham feeding, details of delayed anastomosis, thoracoscopic pouch mobilization and placement of traction sutures as novel technique, replacement techniques, and follow-up. Consensus ≥75% was achieved on 90 items (93%), e.g., definition of long gap, routine pyloroplasty in gastric transposition, and avoidance of preoperative bougienage to enable delayed anastomosis. Nineteen items (20%), e.g., methods of gap measurement were discussed controversially (range 1-9).

    CONCLUSION:  This is the first consensus conference on the perioperative, surgical, and long-term management of patients with long-gap esophageal atresia. Substantial statements regarding esophageal reconstruction or replacement and follow-up were formulated which may contribute to improve patient care.

    OriginalsprogEngelsk
    TidsskriftEuropean Journal of Pediatric Surgery
    Vol/bind31
    Udgave nummer3
    Sider (fra-til)214-225
    Antal sider12
    ISSN0939-7248
    DOI
    StatusUdgivet - jun. 2021

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