Endoscopic management of esophageal mucosal bridges in children with esophageal atresia
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Published:2023-10-13
Issue:12
Volume:37
Page:9167-9172
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ISSN:0930-2794
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Container-title:Surgical Endoscopy
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language:en
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Short-container-title:Surg Endosc
Author:
Antoine MatthieuORCID, Krishnan Usha, Manfredi Michael, Cervinskiene Julija, Viala Jérôme, Brendel Julia, Tzivinikos Christos, Vanrenterghem Audrey, Dimitrov Georges, Hauser Bruno, Laverdure Noémie, Rohmer Barbara, Behal Hélène, Nicolas Audrey, Gottrand Frédéric
Abstract
Abstract
Background and study aims
Esophageal mucosal bridge (EMB) may be diagnosed at the anastomotic site in children operated on for esophageal atresia (EA) but so far only a few cases (n = 4) have been reported. This study aimed to characterize EMB in children with EA, risk factors, and treatment.
Patients and methods
This retrospective multicenter study recorded patient’s characteristics, EMB diagnosis circumstances, endoscopic management, follow-up, and EMB recurrence in children with EA aged less than 18 years, compared with paired EA patients without EMB.
Results
Thirty patients were included (60% male, 90% EA/tracheoesophageal fistula, 43% associated malformations). Compared to 44 paired controls, EMB was associated with a history of nasogastric tube feeding (31% vs. 9.1%, p = 0.02) and severe gastroesophageal reflux disease (history of fundoplication: 41.4% vs. 13.6%, p < 0.01). 77% had symptoms (food impaction and/or dysphagia). Endoscopic management was performed in 53% of patients (83% electrocoagulation) with no technical difficulties or complications. 80% of the symptomatic patients with EMB improved after endoscopic treatment, independently of anastomotic stricture dilatation or not.
Conclusion
EMB endoscopic management by electrocoagulation is safe and often leads to symptom improvement.
Publisher
Springer Science and Business Media LLC
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