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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Zani, A; Eaton, S; Hoellwarth, ME; Puri, P; Tovar, J; Fasching, G; Bagolan, P; Lukac, M; Wijnen, R; Kuebler, JF; Cecchetto, G; Rintala, R; Pierro, A.
International survey on the management of esophageal atresia.
Eur J Pediatr Surg. 2014; 24(1):3-8 Doi: 10.1055/s-0033-1350058 [OPEN ACCESS]
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Co-Autor*innen der Med Uni Graz
Höllwarth Michael
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Abstract:
Because many aspects of the management of esophageal atresia (EA) are still controversial, we evaluated the practice patterns of this condition across Europe. A survey was completed by 178 delegates (from 45 [27 European] countries; 88% senior respondents) at the EUPSA-BAPS 2012. Approximately 66% of respondents work in centers where more than five EA repairs are performed per year. Preoperatively, 81% of respondents request an echocardiogram, and only 43% of respondents routinely perform preoperative bronchoscopy. Approximately 94% of respondents prefer an open approach, which is extrapleural in 71% of respondents. There were no differences in use of thoracoscopy between Europeans (10%) and non-Europeans (11%, p = nonsignificant). Approximately 60% of respondents measure the gap intraoperatively. A transanastomotic tube (90%) and chest drain (69%) are left in situ. Elective paralysis is adopted by 56% of respondents mainly for anastomosis tension (65%). About 72% of respondents routinely request a contrast study on postoperative day 7 (2-14). Approximately 54% of respondents use parenteral nutrition, 40% of respondents start transanastomotic feeds on postoperative day 1, and 89% of respondents start oral feeds after postoperative day 5. Pure EA: 46% of respondents work in centers that repair two or more than two pure EA a year. About 60% of respondents opt for delayed primary anastomosis at 3 months (1-12 months) with gastrostomy formation without esophagostomy. Anastomosis is achieved with open approach by 85% of respondents. About 47% of respondents attempt elongation of esophageal ends via Foker technique (43%) or with serial dilations with bougies (41%). Approximately 67% of respondents always attempt an anastomosis. Gastric interposition is the commonest esophageal substitution. Many aspects of EA management are lacking consensus. Minimally invasive repair is still sporadic. We recommend establishment of an EA registry. Georg Thieme Verlag KG Stuttgart · New York.
Find related publications in this database (using NLM MeSH Indexing)
Anastomosis, Surgical -
Bronchoscopy - statistics & numerical data
Congresses as Topic -
Cross-Cultural Comparison -
Data Collection -
Echocardiography - statistics & numerical data
Esophageal Atresia - diagnosis
Esophageal Atresia - surgery
Europe -
Feeding Methods -
Humans -
Infant -
Infant, Newborn -
Minimally Invasive Surgical Procedures - statistics & numerical data
Postoperative Care -
Preoperative Care -
Stomach - surgery
Surveys and Questionnaires -
Thoracoscopy - statistics & numerical data
Tracheoesophageal Fistula - diagnosis
Tracheoesophageal Fistula - surgery
Utilization Review - statistics & numerical data

Find related publications in this database (Keywords)
esophageal atresia
thoracoscopy
pure esophageal atresia
esophageal replacement
Europe
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