Extrathoracic esophageal elongation with Foker technique in patients with Type-A esophageal atresia. A case series

Mei-Chun Lin; Veronica Polit-Guerrero; Jimmy Andrade-Montesdeoca; Daniel  Acosta-Farina; Vicente Salinas-Salinas; Daniel E. Acosta

doi:10.47338/jns.v12.1221

Authors

Mei-Chun Lin Universidad Catolica Santiago de Guayaquil/ Dr. Roberto Gilbert Children´s hospital https://orcid.org/0000-0001-8268-4271
Veronica Polit-Guerrero Universidad Catolica Santiago de Guayaquil/ Dr. Roberto Gilbert Children´s hospital https://orcid.org/0000-0002-2060-6590
Jimmy Andrade-Montesdeoca Universidad Catolica Santiago de Guayaquil/ Dr. Roberto Gilbert Children´s hospital https://orcid.org/0000-0002-3748-4585
Daniel Acosta-Farina Dr. Roberto Gilbert Children´s hospital/ Universidad Catolica Santiago de Guayaquil https://orcid.org/0000-0002-9655-2824
Vicente Salinas-Salinas Dr. Roberto Gilbert Children´s hospital https://orcid.org/0000-0002-0007-3168
Daniel E. Acosta Mount Sinai Hospital. Chicago https://orcid.org/0000-0003-2709-1937

DOI:

https://doi.org/10.47338/jns.v12.1221

Keywords:

Esophageal atresia, Long-gap, Foker technique, Elongation

Abstract

Background: Long-gap esophageal atresia (EA) is not amenable to primary anastomosis though the goal of surgical treatment is to restore the patency in the native esophagus; the Foker technique is one of the methods that can accomplish it.

Case Presentation: This case series consists of three patients who presented with a type-A long-gap EA. Extrathoracic esophageal elongation was achieved using the Foker technique. During the first stage, we utilized pledgeted sutures reinforced with titanium clips for elongation that began five days after the surgery. As the elongation progressed, and the gap between esophageal pouches decreased, we restored the continuity of the esophagus. On follow-up, all patients needed pneumatic dilatation of the esophagus.

Conclusion: The Foker technique successfully restored the esophageal continuity using the native esophagus in our patients with esophageal atresia.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Oliver DH, Martin S, Belkis DMI, Lucas WM, Steffan L. Favorable outcome of electively delayed elongation procedure in long-gap esophageal atresia. Front Surg. 2021; 8:1-8. Available from: https://doi.org/10.3389/fsurg.2021.701609.

Shieh HF, Jennings RW. Long-gap esophageal atresia. Semin Pediatr Surg. 2017; 26:72–7. Available from: https://doi.org/10.1053/j.sempedsurg.2017.02.009.

Janek K, Meagher D, Goodwin C. Suture fistula revisited for long gap esophageal atresia. J Pediatr Surg. 2019; 54:600–3. Available from: https://doi.org/10.1016/j.jpedsurg.2018.10.100.

Svetanoff WJ, Zendejas B, Hernandez K, Davidson K, Ngo P, Manfredi M, et al. Contemporary outcomes of the Foker process and evolution of treatment algorithms for long-gap esophageal atresia. J Pediatr Surg. 2021; 56:2180–91. Available from: https://doi.org/10.1016/j.jpedsurg.2021.02.054.

Sroka M, Wachowiak R, Losin M, Szlagatys-Sidorkiewicz A, Landowski P, Czauderna P, et al. The Foker technique (FT) and Kimura advancement (KA) for the treatment of children with long-gap esophageal atresia (LGEA): Lessons learned at two European centers. Eur J Pediatr Surg. 2013; 23:3-7. Available from: https://doi.org/10.1055/s-0033-1333891.

Harrington AW, Riebold J, Hernandez K, Staffa SJ, Svetanoff WJ, Zurakowski D, et al. Nutrition delivery and growth outcomes in infants with long-gap esophageal atresia who undergo the Foker process. J Pediatr Surg. 2021; 56:2133–9. Available from: https://doi.org/10.1016/j.jpedsurg.2021.07.014.

Bairdain S, Hamilton TE, Smithers CJ, Manfredi M, Ngo P, Gallagher D, et al. Foker process for the correction of long gap esophageal atresia: Primary treatment versus secondary treatment after prior esophageal surgery. J Pediatr Surg. 2015; 50:933-7. Available from: https://doi.org/10.1016/j.jpedsurg.2015.03.010.

Toczewski K, Gerus S, Kaczorowski M, Kozuń M, Wolicka J, Bobrek K, et al. Biomechanics of esophageal elongation with traction sutures on experimental animal model. Sci Rep. 2022; 12:1-8. Available from: https://doi.org/10.1038/s41598-022-07348-4.

Barksdale E, Bobanga I. Foker technique for the management of pure esophageal atresia: Long-term outcomes at a single institution. Eur J Pediatr Surg. 2015; 26:215–8. Available from: https://doi.org/10.1055/s-0035-1546757

Petrone E, Santini G, Lista R, Russo S, Gaglione G. Long gap esophageal atresia repair using the Foker technique: a 19 years experience. Minerva Pediatr (Torino). 2022; Available from: https://doi.org/10.23736/s2724-5276.22.06946-4.