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- Title
Repair of esophageal atresia with proximal fistula using endoscopic magnetic compression anastomosis (magnamosis) after staged lengthening.
- Authors
Dorman, Robert; Vali, Kaveh; Harmon, Carroll; Zaritzky, Mario; Bass, Kathryn; Dorman, Robert M; Harmon, Carroll M; Bass, Kathryn D
- Abstract
We describe the treatment of a patient with long-gap esophageal atresia with an upper pouch fistula, mircogastria and minimal distal esophageal remnant. After 4.5 months of feeding via gastrostomy, a proximal fistula was identified by bronchoscopy and a thoracoscopic modified Foker procedure was performed reducing the gap from approximately 7-5 cm over 2 weeks of traction. A second stage to ligate the fistula and suture approximate the proximal and distal esophagus resulted in a gap of 1.5 cm. IRB and FDA approval was then obtained for endoscopic placement of 10-French catheter mounted magnets in the proximal and distal pouches promoting a magnetic compression anastomosis (magnamosis). Magnetic coupling occurred at 4 days and after magnet removal at 13 days an esophagram demonstrated a 10 French channel without leak. Serial endoscopic balloon dilation has allowed drainage of swallowed secretions as the baby learns bottling behavior at home.
- Subjects
ESOPHAGEAL atresia; GASTROSTOMY; ENDOSCOPIC surgery; TRANSLUMINAL angioplasty; SURGICAL anastomosis; DRUG approval; THERAPEUTICS
- Publication
Pediatric Surgery International, 2016, Vol 32, Issue 5, p525
- ISSN
0179-0358
- Publication type
journal article
- DOI
10.1007/s00383-016-3889-y