TY - JOUR

T1 - ERNICA Consensus Conference on the Management of Patients with Long-Gap Esophageal Atresia

T2 - Perioperative, Surgical, and Long-Term Management

AU - Dingemann, Carmen

AU - Eaton, Simon

AU - Aksnes, Gunnar

AU - Bagolan, Pietro

AU - Cross, Kate M

AU - De Coppi, Paolo

AU - Fruithof, JoAnne

AU - Gamba, Piergiorgio

AU - Goldschmidt, Imeke

AU - Gottrand, Frederic

AU - Pirr, Sabine

AU - Rasmussen, Lars

AU - Sfeir, Rony

AU - Slater, Graham

AU - Suominen, Janne

AU - Svensson, Jan F

AU - Thorup, Joergen M

AU - Tytgat, Stefaan H A J

AU - van der Zee, David C

AU - Wessel, Lucas

AU - Widenmann-Grolig, Anke

AU - Wijnen, René

AU - Zetterquist, Wilhelm

AU - Ure, Benno M

N1 - Georg Thieme Verlag KG Stuttgart · New York.

PY - 2021

Y1 - 2021

N2 - 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.

AB - 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.

U2 - 10.1055/s-0040-1713932

DO - 10.1055/s-0040-1713932

M3 - Journal article

C2 - 32668485

VL - 31

SP - 214

EP - 225

JO - European Journal of Pediatric Surgery, Supplement

JF - European Journal of Pediatric Surgery, Supplement

SN - 0939-6764

IS - 3

ER -