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Article Dans Une Revue European Journal of Pediatric Surgery Année : 2020

Ernica consensus conference on the management of patients with long-gap esophageal atresia: perioperative, surgical, and long-term management

Joanne Fruithof
  • Fonction : Auteur

Résumé

BACKGROUND:  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. 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). CONCLUSIONS:  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.

Dates et versions

hal-04040502 , version 1 (28-04-2023)

Identifiants

Citer

Carmen Dingemann, Simon Eaton, Gunnar Aksnes, Pietro Bagolan, Kate M. Cross, et al.. Ernica consensus conference on the management of patients with long-gap esophageal atresia: perioperative, surgical, and long-term management. European Journal of Pediatric Surgery, 2020, European journal of pediatric surgery official journal of Austrian Association of Pediatric Surgery .. [et al] = Zeitschrift fur Kinderchirurgie, 31 (3), pp.214-225. ⟨10.1055/s-0040-1713932⟩. ⟨hal-04040502⟩

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