Esophageal atresia & TOF

[center] Esophageal replacement in children; Retrosternal colon transplant For long gap esophageal atresia and caustic stricture Prof Sameh Shehata see in second post[/center]

First one with correct answer with justification win. [size=20px]A four-kg term infant has esophageal atresia with tracheoesophageal fistula (EA/TEF). Echocardiogram shows a left sided aortic arch with no other cardiac abnormalities. The EA/TEF repair is approached using a right thoracotomy and right sided aortic arch is encountered. At this time the best approach for this patient with a right aortic arch would be A close the right thoracotomy and perform the entire repair through a left thoracotomy. B abandon the repair and place a gastrostomy tube. C close the right thoracotomy and perform the repair through a median sternotomy. D return in six weeks t…

First one with correct answer with justification win. [size=20px]A two-kilogram male neonate with esophageal atresia and distal tracheoesophageal fistula underwent primary repair through a right thoracotomy at two days of age. Two days after repair the baby started having more respiratory distress and copious salivary output through the chest tube. The baby was otherwise physiologically well. A chest radiograph showed a large pneumothorax that did not resolve with stripping the chest tube or increasing the negative pressure on the tube. A contrast study shows full extravasation of contrast into the chest with no contrast going distally. During chest re-exploration the …

First correct answer win [size=20px]A 1800 gram newborn undergoes extrapleural repair of a proximal esophageal atresia and distal tracheoesophageal fistula. On POD 1, she requires emergent reintubation and develops a continuous air leak from the chest tube. Chest x-ray shows a large pneumothorax. What is the most appropriate management?[/size] [size=20px]A Esophagram B Switch to HFOV C Place a second chest tube D Bronchoscopy E Reoperation[/size]

see video in second post

First one with correct answer with justification win. [size=20px]A full term infant weighing 3.2 kgs is born with esophageal atresia (EA) with a proximal pouch and distal fistula. A right thoracotomy is performed. The fistula is divided. However, the two ends of the esophagus are separated by over five cm. The next step best step in management of this patient with long gap EA is A esophageal myotomy. B cervical esophagostomy. C gastrostomy. D reverse gastric tube. E colon interposition.[/size]

First one with correct answer with justification win. [size=20px]A child born with esophageal atresia has a chest radiograph suspicious for a right sided aortic arch. An echocardiogram fails to reveal any additional abnormalities. The next best step in management of this patient with esophageal atresia and suspected right sided aortic arch is A bronchoscopy. B thoracoscopy. C computerized tomography angiography. D right thoracotomy. E left thoracotomy.[/size]

First one with correct answer with justification win. [size=20px]A newborn infant presents with pure esophageal atresia. A gastrostomy is performed and a contrast study reveals a five vertebral body distance between the proximal and distal esophageal pouches. Which of the following approaches will result in the shortest time to definitive anastomosis for patients with long gap esophageal atresia? A delayed primary repair B the application of traction sutures (Foker technique) C gastric pull up D colon interposition E serial extrathoracic proximal esophageal advancement (Kimura technique)[/size]

First one with correct answer with justification win. A 2.5-kg neonate with esophageal atresia and distal tracheoesophageal fistula undergoes a thoracoscopic primary repair on the second day of life. Salivary drainage is noted in the chest tube on postoperative day seven. A contrast study confirms controlled extravasation at the anastomosis. [size=20px]The most appropriate initial management of this patient with an esophageal anastomotic leak is A nothing by mouth, broad spectrum antibiotics and total parenteral nutrition. B endoscopic placement of a stent across the anastomosis. C right thoracoscopy with repair of the anastomosis. D right thoracot…

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What is your hospital/center experience with thoracoscopy in TOF repair ?