Early Management of Esophageal Leak in Esophageal Atresia: Changing Paradigms

Background: Esophageal atresia is rare congenital anomaly, which is traditionally repaired by open thoracotomy. Thoracoscopic esophageal atresia repair has evolved as an effective and safe technique.Material and Methods: This is a retrospective review of 11 cases of esophageal atresia (type C), between June 2015 to May 2016. The objective of study is to describe our initial learning curve of thoracoscopic esophageal atresia repair.Results: Out of 11 patients, initial 4 underwent video assisted technique through single incision of 2 cm to visualize the exact video-scopic anatomy and to do few steps if possible. In last 7 cases, steps were completed with both ends mobilization and intracorporeally single layer interrupted stitching of esophagus. Complications encountered in 3 patients like esophageal leak in one managed conservatively, stenosis and reflux in one patient each.Conclusion: Thoracoscopic esophageal atresia repair is challenging and demanding surgery. Every surgeon has a learning curve before successful thoracoscopic repair which requires skills and learning under supervision of experienced surgeons.

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Early management of infants with epidermolysis bullosa

Clinical and Experimental Dermatology ◽

10.1046/j.1365-2230.2001.00802-11.x ◽

2001 ◽

Vol 26 (2) ◽

pp. 213-213

Author(s):

Jacqueline Denyer

Keyword(s):

Epidermolysis Bullosa ◽

Early Management

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Combined tracheal and esophageal atresia with fatal outcome

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-0036-1587907 ◽

2016 ◽

Vol 37 (S 01) ◽

Author(s):

S Kehl ◽

TM Völkl ◽

F Baier ◽

T Hildebrandt ◽

MW Beckmann ◽

...

Keyword(s):

Esophageal Atresia ◽

Fatal Outcome

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Esophageal Atresia and Associated Duodenal Atresia: A Cohort Study and Review of the Literature

European Journal of Pediatric Surgery ◽

10.1055/s-0040-1716884 ◽

2020 ◽

Author(s):

Maria Enrica Miscia ◽

Giuseppe Lauriti ◽

Dacia Di Renzo ◽

Angela Riccio ◽

Gabriele Lisi ◽

...

Keyword(s):

Cohort Study ◽

Esophageal Atresia ◽

Primary Repair ◽

English Literature ◽

Delayed Diagnosis ◽

Case Series ◽

Primary Treatment ◽

Duodenal Atresia ◽

Staged Approach ◽

Missed Diagnosis

Abstract Introduction Esophageal atresia (EA) is associated with duodenal atresia (DA) in 3 to 6% of cases. The management of this association is controversial and literature is scarce on the topic. Materials and Methods We aimed to (1) review the patients with EA + DA treated at our institution and (2) systematically review the English literature, including case series of three or more patients. Results Cohort study: Five of seventy-four patients with EA had an associated DA (6.8%). Four of five cases (80%) underwent primary repair of both atresia, one of them with gastrostomy placement (25%). One of five cases (20%) had a delayed diagnosis of DA. No mortality has occurred. Systematic Review: Six of six-hundred forty-five abstract screened were included (78 patients). Twenty-four of sixty-eight (35.3%) underwent primary correction of EA + DA, and 36/68 (52.9%) underwent staged correction. Nine of thirty-six (25%) had a missed diagnosis of DA. Thirty-six of sixty-eight underwent gastrostomy placement. Complications were observed in 14/36 patients (38.9 ± 8.2%). Overall mortality reported was 41.0 ± 30.1% (32/78 patients), in particular its incidence was 41.7 ± 27.0% after a primary treatment and 37.0 ± 44.1% following a staged approach. Conclusion The management of associated EA and DA remains controversial. It seems that the staged or primary correction does not affect the mortality. Surgeons should not overlook DA when correcting an EA.

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Systematic review of cervical cancer prevalence and determinants of early detection in Sub-Saharan Africa

KIBOGORA POLYTECHNIC SCIENTIFIC JOURNAL ◽

10.33618/kpscj.2018.01.006 ◽

2018 ◽

Vol 1 (1) ◽

pp. 32-36

Author(s):

Eleazar Ndabarora ◽

Dariya Mukamusoni ◽

Clarte Ndikumasabo ◽

Védaste Ngirinshuti

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Early Detection ◽

Cervical Cancer Screening ◽

Sub Saharan Africa ◽

Extensive Literature ◽

Early Management ◽

Screening Programs ◽

Mesh Terms ◽

Sub Saharan

Cervical cancer is one of the leading causes of morbidity and mortality globally and in Sub-Saharan Africa in particular. There is evidence that early detection and early management of cases are the best strategies to prevent and control this health threat, since treatment of the later stages of the diseases are very expensive. The objectives of the review were: (1) to identify and review studies on the prevalence of cervical cancer and determinants of early detection in Sub-Saharan Africa, and (2) to recommend further studies and interventions based on the findings of this review. Extensive literature search was conducted using the MeSH terms. Articles on cervical cancer and/or determinants of early detection which fulfilled inclusion criteria were reviewed independently by three reviewers. The prevalence of cervical cancer in Sub-Saharan Africa is increasing. Although there are evidences that cervical cancer screening programs are practical and feasible even in resource-limited settings in Sub-Saharan Africa, there is a very low uptake of cervical cancer screening and there are key factors that need to be addressed in order to make these programs established and effective.

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