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ERNICA Consensus conference on the management of patients with long-gap esophageal Atresia: Perioperative, Surgical, and Long-Term Management

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 referrin...

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Main Authors: Dingemann, Carmen (Author) , Eaton, Simon (Author) , Aksnes, Gunnar (Author) , Bagolan, Pietro (Author) , Cross, Kate M. (Author) , Coppi, Paolo De (Author) , Fruithof, JoAnne (Author) , Gamba, Piergiorgio (Author) , Goldschmidt, Imeke (Author) , Gottrand, Frederic (Author) , Pirr, Sabine (Author) , Rasmussen, Lars (Author) , Sfeir, Rony (Author) , Slater, Graham (Author) , Suominen, Janne (Author) , Svensson, Jan F. (Author) , Thorup, Joergen M. (Author) , Tytgat, Stefaan H. A. J. (Author) , Zee, David C. van der (Author) , Wessel, Lucas (Author) , Widenmann-Grolig, Anke (Author) , Wijnen, René (Author) , Zetterquist, Wilhelm (Author) , Ure, Benno M. (Author)
Format: Article (Journal)
Language:English
Published: July 15, 2020
In: European journal of pediatric surgery
Year: 2021, Volume: 31, Issue: 03, Pages: 214-225
ISSN:1439-359X
DOI:10.1055/s-0040-1713932
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1055/s-0040-1713932
Verlag, lizenzpflichtig, Volltext: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1713932
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Author Notes: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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Summary: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.
Item Description:Gesehen am 28.08.2021
Physical Description:Online Resource
ISSN:1439-359X
DOI:10.1055/s-0040-1713932

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