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

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  • 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 Wessel
  • Anke Widenmann-Grolig
  • René Wijnen
  • Wilhelm Zetterquist
  • Benno M Ure
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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.

Original languageEnglish
JournalEuropean Journal of Pediatric Surgery
Volume31
Issue number3
Pages (from-to)214-225
Number of pages12
ISSN0939-7248
DOIs
Publication statusPublished - Jun 2021

    Research areas

  • consensus conference, follow-up, long-gap esophageal atresia, management, pediatric surgery

ID: 62426790