[size=20px]During attempted thoracoscopic repair of an isolated esophageal atresia in an otherwise healthy full term infant, there is still a three cm gap between the two ends of the esophagus after aggressive surgical mobilization. You proceed to place traction sutures on both ends of the esophagus (i.e. Foker technique).

 

The expectation that you will be able to achieve a primary esophageal anastomosis at subsequent thoracoscopy or thoracotomy is

 

A 0.5 percent.

 

B 1 percent.

 

C 25 percent.

 

D 50 percent.

 

E 80 percent.[/size]

(Untitled)

 

e

e

correct

 

The ideal management of an infant with long gap esophageal atresia (EA) continues to be controversial. A common approach is to place an early gastrostomy tube and wait several months before attempting a primary esophagoesophagostomy either via thoracoscopy or thoracotomy. However, other surgeons have advocated early gastric transposition. Recently, a number of reports have again emphasized the importance of making every effort to preserve the native esophagus. Other studies have emphasized good success with primary thoracoscopic repair in long gap EA within four to eight weeks or the use of early primary traction sutures in the first weeks of life without a gastrostomy. In several series the success rate of obtaining a primary esophageal anastomosis using the Foker traction technique in the first months of life is about 80%.