{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T17:59:06Z","timestamp":1782410346001,"version":"3.54.5"},"reference-count":38,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:p>\n            Objective\u2003Management of long gap esophageal atresia (LGOA) is controversial. This study aims at comparing the management of LGOA between two high-volume centers.<\/jats:p><jats:p>\n            Methods\u2003We included patients with LGOA (type A and B) between 2008 and 2022. Demographics, surgical methods, and outcomes were collected and compared.<\/jats:p><jats:p>\n            Results\u2003The study population involved 28 patients in center A and 24 patients in center B. A surgical approach was thoracoscopic in center A, only for one patient was open for final procedure. In center B, 3 patients were treated only thoracoscopically, 2 converted to open, and 19 as open surgery. In center A primary esophageal anastomosis concerned 1 case, two-staged esophageal lengthening using external traction 1 patient, and 26 were treated with the multistaged internal traction technique. In 24 patients a full anastomosis was achieved: in 23 patients only the internal traction technique was used, while 1 patient required open Collis\u2013Nissen procedure as final management. In center B primary anastomosis was performed in 7 patients, delayed esophageal anastomosis in 8 patients, esophageal lengthening using external traction in 1 case, and 9 infants required esophageal replacement with gastric tube. Analyzed postoperative complications included: early mortality, 2\/28 due to accompanied malformations (center A) and 0\/24 (center B); anastomotic leakage, 4\/26 (center A) treated conservatively\u2014all patients had a contrast study\u2014and 0\/24 (center B), 1 case of pleural effusion, but no routine contrast study; recurrent strictures, 13\/26 (center A) and 7\/15 (center B); and need for fundoplication, 5\/26 (center A) and 2\/15 (center B). Age at esophageal continuity was as a median of 31 days in center A and 110 days in center B. Median time between initial procedure and esophageal anastomosis was 11 days in center A and 92 days in center B.<\/jats:p><jats:p>\n            Conclusion\u2003Thoracoscopic internal traction technique reduces time to achieve esophageal continuity and the need for esophageal substitution while maintaining a similar early complication rate.<\/jats:p>","DOI":"10.1055\/a-2235-8766","type":"journal-article","created":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T23:54:12Z","timestamp":1703807652000},"page":"036-043","source":"Crossref","is-referenced-by-count":17,"title":["Thoracoscopic Stage Internal Traction Repair Reduces Time to Achieve Esophageal Continuity in Long Gap Esophageal Atresia"],"prefix":"10.1055","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4880-8047","authenticated-orcid":false,"given":"Dominika","family":"Borselle","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery and Urology, Wroclaw Medical University, Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Davidson","sequence":"additional","affiliation":[{"name":"Great Ormond Street Institute of Child Health, University College London, London, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavros","family":"Loukogeorgakis","sequence":"additional","affiliation":[{"name":"Great Ormond Street Institute of Child Health, University College London, London, United Kingdom of Great Britain and Northern Ireland"},{"name":"Department of Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital for Children, NIHR, London, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1659-0207","authenticated-orcid":false,"given":"Paolo","family":"De Coppi","sequence":"additional","affiliation":[{"name":"Great Ormond Street Institute of Child Health, University College London, London, United Kingdom of Great Britain and Northern Ireland"},{"name":"Department of Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital for Children, NIHR, London, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dariusz","family":"Patkowski","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery and Urology, Wroclaw Medical University, Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,1,22]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.3389\/fped.2017.00063","article-title":"Position paper of INoEA working group on long gap esophageal atresia: for better care","volume":"5","author":"D C van der Zee","year":"2017","journal-title":"Front Pediatr"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1016\/j.jpedsurg.2018.12.019","article-title":"Management of long gap esophageal atresia: a systematic review and evidence-based guidelines from the APSA Outcomes and Evidence Based Practice Committee","volume":"54","author":"R Baird","year":"2019","journal-title":"J Pediatr Surg"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1055\/s-0040-1713932","article-title":"ERNICA consensus conference on the management of patients with long-gap esophageal atresia: perioperative, surgical, and long-term management","volume":"31","author":"C Dingemann","year":"2021","journal-title":"Eur J Pediatr Surg"},{"key":"ref4","first-page":"51","volume-title":"Intrathoracic intracorporeal thoracoscopic elongation \u2013 internal traction","author":"D Patkowski","year":"2021"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1053\/j.sempedsurg.2008.10.009","article-title":"The surgical approach to esophageal atresia repair and the management of long-gap atresia: results of a survey","volume":"18","author":"O Ron","year":"2009","journal-title":"Semin Pediatr Surg"},{"issue":"11","key":"ref6","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1089\/lap.2015.0124","article-title":"Experience with thoracoscopic repair of long gap esophageal atresia in neonates","volume":"25","author":"S S Rothenberg","year":"2015","journal-title":"J Laparoendosc Adv Surg Tech A"},{"issue":"10","key":"ref7","first-page":"1635","article-title":"Esophageal atresia. 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