{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T23:20:00Z","timestamp":1791069600110,"version":"4.1.0"},"reference-count":9,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T00:00:00Z","timestamp":1705536000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPGN rep."],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Endoscopic vacuum\u2010assisted therapy offers an easier and safer alternative to thoracic surgery, self\u2010expanding stents, or esophageal clips and has been shown to be a promising technique for management of pediatric esophageal perforations. In this report, we present a novel application of a percutaneous endoscopic gastrostomy\u2010assisted pull technique, wherein a preexisting gastrostomy is reaccessed to allow safe placement of the vacuum sponge with a more comfortable and effective endoscopic vacuum\u2010assisted closure therapy compared to transnasal or transoral options. A 7\u2010year\u2010old male with a history of type C esophageal atresia with distal tracheoesophageal fistula complicated by leak and refractory esophageal stricture, severe tracheomalacia, and prior esophageal stricture resection presented for posterior tracheoplasty and tracheopexy complicated by esophageal perforation. A preexisting gastrostomy site was re\u2010accessed to allow for a novel approach for endoluminal sponge placement in endoscopic vacuum\u2010assisted closure (EVAC) therapy by gastrostomy\u2010assisted pull technique. The patient had appropriate healing without further leak 1 month after repair. This case highlights the use of EVAC as a minimally invasive option for repair of esophageal perforation using a pull\u2010through method at the percutaneous endoscopic gastrostomy tube site as gastric access. This method may improve control of placement and reduce sponge migration, reduce intraluminal distance of sponge placement, and reduce morbidity by avoiding thoracotomy.<\/jats:p>","DOI":"10.1002\/jpr3.12040","type":"journal-article","created":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T05:39:25Z","timestamp":1705642765000},"page":"74-78","source":"Crossref","is-referenced-by-count":2,"title":["Pulling instead of pushing: A case report of gastrostomy\u2010assisted pull technique as an alternative method for endoluminal sponge placement in EVAC therapy"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0933-5045","authenticated-orcid":false,"given":"Carolena","family":"Trocchia","sequence":"first","affiliation":[{"name":"Department of Pediatrics Johns Hopkins All Children's Hospital Saint Petersburg Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hester F.","family":"Shieh","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Johns Hopkins All Children's Hospital Saint Petersburg Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Dolan","sequence":"additional","affiliation":[{"name":"Denison University Granville Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Wilsey","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology Johns Hopkins All Children's Hospital Saint Petersburg Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles J.","family":"Smithers","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Johns Hopkins All Children's Hospital Saint Petersburg Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3345\/kjp.2018.61.6.175"},{"key":"e_1_2_8_3_1","first-page":"102","article-title":"Esophageal perforation in children: a review of one pediatric surgery institution's experience (16 years)","volume":"26","author":"Vieira E","year":"2013","journal-title":"Acta Med Port"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000002073"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1149-1741"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1222-3191"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481708300846"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-022-02346-2"},{"issue":"5","key":"e_1_2_8_9_1","first-page":"E686","article-title":"Endoscopic vacuum therapy (EVT) for acute esophageal perforation: could it replace surgery?","volume":"1010","author":"Stathopoulos P","year":"2022","journal-title":"Endosc Int Open"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000003207"}],"container-title":["JPGN Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jpr3.12040","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T15:43:02Z","timestamp":1708962182000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jpr3.12040"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,18]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1002\/jpr3.12040"],"URL":"https:\/\/doi.org\/10.1002\/jpr3.12040","archive":["Portico"],"relation":{},"ISSN":["2691-171X","2691-171X"],"issn-type":[{"value":"2691-171X","type":"print"},{"value":"2691-171X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,18]]}}}