{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T16:21:57Z","timestamp":1789402917266,"version":"build-2803163510"},"reference-count":40,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction\u2003Long-gap esophageal atresia represents a distinct entity among the esophageal atresia spectrum. In many patients, achieving a reasonable anastomosis depends on some millimeters of tissue. We aimed to determine what effect the suturing technique would have on esophageal ex vivo elongation as it may determine the strength of a primary anastomosis.<\/jats:p><jats:p>\n          Materials and Methods\u2003In an analysis of porcine esophagi from animals for slaughter (100\u2013120 days old with a weight of 100\u2013120\u2009kg), we determined esophageal length gain of simple continuous and simple interrupted suture anastomoses subjected to linear traction until linear breaking strength was reached. Statistical power of 80% was ensured based on an a priori power analysis using five specimens per group in a separate exploratory experiment.<\/jats:p><jats:p>\n          Results\u2003The simple continuous suture anastomosis in 15 porcine esophagi (\n            \n          \u2009=\u20094.47\u2009cm, 95% confidence interval: 4.08\u20134.74\u2009cm) outperformed the simple interrupted suture anastomosis in another 15 esophagi (\n            \n          \u2009=\u20093.03\u2009cm, 95% confidence interval: 2.59\u20133.43\u2009cm) in length gain (\u0394 = 1.44\u2009cm, 95% confidence interval: 0.87\u20132.01\u2009cm, p\u2009&lt;\u20090.0001).<\/jats:p><jats:p>\n          Conclusion\u2003Simple continuous anastomoses achieved higher length gain compared with simple interrupted suture anastomoses. This effect warrants an experimental assessment in vivo to assess its potential merits for clinical applicability.<\/jats:p>","DOI":"10.1055\/s-0040-1710025","type":"journal-article","created":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T22:55:24Z","timestamp":1589842524000},"page":"177-181","source":"Crossref","is-referenced-by-count":4,"title":["A Continuous Suture Anastomosis Outperforms a Simple Interrupted Suture Anastomosis in Esophageal Elongation"],"prefix":"10.1055","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3469-777X","authenticated-orcid":false,"given":"Christina","family":"Oetzmann von Sochaczewski","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Universit\u00e4tsmedizin der Johannes-Gutenberg-Universit\u00e4t, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Tagkalos","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplant Surgery, Universit\u00e4tsmedizin der Johannes-Gutenberg-Universit\u00e4t, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Lindner","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Universit\u00e4tsmedizin der Johannes-Gutenberg-Universit\u00e4t, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hauke","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplant Surgery, Universit\u00e4tsmedizin der Johannes-Gutenberg-Universit\u00e4t, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Heimann","sequence":"additional","affiliation":[{"name":"Institute for Neurosurgical Pathophysiology, Universit\u00e4tsmedizin der Johannes-Gutenberg-Universit\u00e4t, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver J.","family":"Muensterer","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Universit\u00e4tsmedizin der Johannes-Gutenberg-Universit\u00e4t, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,5,18]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1159\/000449241","article-title":"Long-gap esophageal atresia is a unique entity within the esophageal atresia defect spectrum","volume":"111","author":"S Bairdain","year":"2017","journal-title":"Neonatology"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1097\/00000658-199710000-00014","article-title":"Development of a true primary repair for the full spectrum of esophageal atresia","volume":"226","author":"J E Foker","year":"1997","journal-title":"Ann Surg"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1053\/j.sempedsurg.2004.10.021","article-title":"A flexible approach to achieve a true primary repair for all infants with esophageal atresia","volume":"14","author":"J E Foker","year":"2005","journal-title":"Semin Pediatr Surg"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/S0929-693X(00)00193-7","article-title":"St\u00e9nose anastomotique apr\u00e8s traitement chirurgical de l'atr\u00e9sie de l'\u0153sophage\u202f: fr\u00e9quence, facteurs de risque et efficacit\u00e9 des dilatations \u0153sophagiennes","volume":"8","author":"L Michaud","year":"2001","journal-title":"Arch Pediatr"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1186\/s13023-014-0206-5","article-title":"Results from the French National Esophageal Atresia register: one-year outcome","volume":"9","author":"A Schneider","year":"2014","journal-title":"Orphanet J Rare Dis"},{"issue":"09","key":"ref6","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1016\/S0022-3468(88)80227-6","article-title":"Management of esophageal atresia: review of 16 years' experience","volume":"23","author":"U Sill\u00e9n","year":"1988","journal-title":"J Pediatr Surg"},{"issue":"07","key":"ref7","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1016\/S0022-3468(05)80018-1","article-title":"Prediction and prevention of anastomotic complications of esophageal atresia and tracheoesophageal fistula","volume":"25","author":"L J McKinnon","year":"1990","journal-title":"J Pediatr Surg"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/0007-1226(88)90049-5","article-title":"The effect of mechanical stress on soft and hard tissue repair; a review","volume":"41","author":"J D Urschel","year":"1988","journal-title":"Br J Plast Surg"},{"issue":"06","key":"ref9","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1016\/j.amjsurg.2013.07.017","article-title":"Determination of independent predictive factors for anastomotic leak: analysis of 682 intestinal anastomoses","volume":"206","author":"B C Morse","year":"2013","journal-title":"Am J Surg"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1016\/j.athoracsur.2018.12.009","article-title":"Esophageal biomechanics revisited: a tale of tenacity, anastomoses, and suture bite lengths in swine","volume":"107","author":"C Oetzmann von Sochaczewski","year":"2019","journal-title":"Ann Thorac Surg"},{"issue":"05","key":"ref11","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1055\/s-0038-1676506","article-title":"Technical aspects in esophageal lengthening: an investigation of traction procedures and suturing techniques in swine","volume":"29","author":"C Oetzmann von Sochaczewski","year":"2019","journal-title":"Eur J Pediatr Surg"},{"issue":"04","key":"ref12","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1159\/000049715","article-title":"Breaking strength of native and sutured trachea. An experimental study on sheep trachea","volume":"33","author":"M Behrend","year":"2001","journal-title":"Eur Surg Res"},{"issue":"03","key":"ref13","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1115\/1.2187033","article-title":"Directional, regional, and layer variations of mechanical properties of esophageal tissue and its interpretation using a structure-based constitutive model","volume":"128","author":"W Yang","year":"2006","journal-title":"J Biomech Eng"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1113\/expphysiol.2013.076091","article-title":"Characterization of the anisotropic mechanical behaviour of colonic tissues: experimental activity and constitutive formulation","volume":"99","author":"E L Carniel","year":"2014","journal-title":"Exp Physiol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.jbiomech.2017.02.029","article-title":"A biomechanical approach to the analysis of methods and procedures of bariatric surgery","volume":"56","author":"E L Carniel","year":"2017","journal-title":"J Biomech"},{"issue":"02","key":"ref16","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences","volume":"39","author":"F Faul","year":"2007","journal-title":"Behav Res Methods"},{"issue":"397","key":"ref17","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1080\/01621459.1987.10478410","article-title":"Better bootstrap confidence intervals","volume":"82","author":"B Efron","year":"1987","journal-title":"J Am Stat Assoc"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1080\/00031305.2015.1089789","article-title":"What teachers should know about the bootstrap: resampling in the undergraduate statistics curriculum","volume":"69","author":"T C Hesterberg","year":"2015","journal-title":"Am Stat"},{"issue":"02","key":"ref20","first-page":"78","article-title":"The piglet in experimental pediatric surgery","volume":"21","author":"A Livaditis","year":"1979","journal-title":"Z Versuchstierkd"},{"issue":"02","key":"ref21","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/s00383-005-1593-4","article-title":"Animal models in pediatric surgery","volume":"22","author":"A Mortell","year":"2006","journal-title":"Pediatr Surg Int"},{"issue":"06","key":"ref22","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1016\/j.jpedsurg.2015.03.011","article-title":"A novel method of esophageal lengthening in a large animal model of long gap esophageal atresia","volume":"50","author":"V F Sullins","year":"2015","journal-title":"J Pediatr Surg"},{"issue":"01","key":"ref23","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1055\/s-0036-1593386","article-title":"The effect of intramural botulinum toxin injections on the elongation of the piglet oesophagus is time dependent","volume":"27","author":"C B Dibbern","year":"2017","journal-title":"Eur J Pediatr Surg"},{"issue":"10","key":"ref24","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1089\/lap.2017.0180","article-title":"Creation of an esophageal atresia animal model using a bifurcated esophagus to maintain digestive tract continuity","volume":"27","author":"I C Glenn","year":"2017","journal-title":"J Laparoendosc Adv Surg Tech A"},{"issue":"03","key":"ref25","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/j.jpedsurg.2018.09.014","article-title":"Magnetic compression anastomosis (magnamosis) in a porcine esophagus: proof of concept for potential application in esophageal atresia","volume":"54","author":"N E Bruns","year":"2019","journal-title":"J Pediatr Surg"},{"issue":"06","key":"ref26","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1055\/s-0038-1676979","article-title":"Esophageal blood flow may not be directly influenced by anastomotic tension: an exploratory laser Doppler study in swine","volume":"29","author":"C Oetzmann von Sochaczewski","year":"2019","journal-title":"Eur J Pediatr Surg"},{"issue":"06","key":"ref27","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1089\/lap.2018.0778","article-title":"Beyond magnamosis: a method to test sutureless esophageal anastomotic devices in living swine by creating an esophageal bypass loop for natural oral nutrition","volume":"29","author":"C Oetzmann von Sochaczewski","year":"2019","journal-title":"J Laparoendosc Adv Surg Tech A"},{"issue":"03","key":"ref28","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.jpedsurg.2019.04.029","article-title":"An experimental study on magnetic esophageal compression anastomosis in piglets","volume":"55","author":"O J Muensterer","year":"2020","journal-title":"J Pediatr Surg"},{"issue":"09","key":"ref29","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1016\/j.jpedsurg.2018.09.024","article-title":"Polyurethane scaffolds seeded with autologous cells can regenerate long esophageal gaps: an esophageal atresia treatment model","volume":"54","author":"T Jensen","year":"2019","journal-title":"J Pediatr Surg"},{"issue":"06","key":"ref30","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1177\/0023677220902184","article-title":"Using multidimensional scaling in model choice for congenital oesophageal atresia: similarity analysis of human autopsy organ weights with those from a comparative assessment of Aachen Minipig and Pietrain piglets","volume":"54","author":"J Baumgart","year":"2020","journal-title":"Lab Anim"},{"issue":"03","key":"ref31","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/S0022-3468(81)80692-6","article-title":"Circular myotomy and esophageal length and safe esophageal anastomosis: an experimental study","volume":"16","author":"Y Takada","year":"1981","journal-title":"J Pediatr Surg"},{"issue":"01","key":"ref32","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1186\/s40064-015-0922-x","article-title":"Tensile properties of the rectal and sigmoid colon: a comparative analysis of human and porcine tissue","volume":"4","author":"M B Christensen","year":"2015","journal-title":"Springerplus"},{"issue":"02","key":"ref33","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1111\/dote.12171","article-title":"Esophageal anastomosis","volume":"28","author":"Y Yuan","year":"2015","journal-title":"Dis Esophagus"},{"issue":"01","key":"ref34","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1111\/nyas.13676","article-title":"Surgical robotics for esophageal cancer","volume":"1434","author":"P P Grimminger","year":"2018","journal-title":"Ann N Y Acad Sci"},{"issue":"07","key":"ref35","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1053\/jpsu.2002.33823","article-title":"Robotic-assisted esophagoesophagostomy","volume":"37","author":"C M Hollands","year":"2002","journal-title":"J Pediatr Surg"},{"issue":"09","key":"ref36","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1016\/j.jpedsurg.2004.05.015","article-title":"Robotically assisted esophago-esophagostomy in newborn pigs","volume":"39","author":"A Lorincz","year":"2004","journal-title":"J Pediatr Surg"},{"issue":"01","key":"ref37","doi-asserted-by":"crossref","first-page":"e55","DOI":"10.1055\/s-0037-1606192","article-title":"Thoracoscopic tracheoesophageal N-fistula repair using a 5.8-mm miniature stapler for fistula division","volume":"5","author":"A-S Holler","year":"2017","journal-title":"Eur J Pediatr Surg Rep"},{"issue":"01","key":"ref38","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1055\/s-0033-1350058","article-title":"International survey on the management of esophageal atresia","volume":"24","author":"A Zani","year":"2014","journal-title":"Eur J Pediatr Surg"},{"issue":"02","key":"ref39","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.jpedsurg.2016.11.010","article-title":"Multicentre survey on the current surgical management of oesophageal atresia in Belgium and Luxembourg","volume":"52","author":"H Reusens","year":"2017","journal-title":"J Pediatr Surg"},{"issue":"05","key":"ref40","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1080\/00015458.2019.1610263","article-title":"Using simple interrupted suture anastomoses may impair translatability of experimental rodent oesophageal surgery","volume":"120","author":"E Tagkalos","year":"2020","journal-title":"Acta Chir Belg"},{"issue":"06","key":"ref41","first-page":"277","article-title":"Oesophageal atresia: the epitome of modern surgery","volume":"54","author":"N A Myers","year":"1974","journal-title":"Ann R Coll Surg Engl"}],"container-title":["European Journal of Pediatric Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1710025.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T11:57:18Z","timestamp":1615204638000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1710025"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,18]]},"references-count":40,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2021,3,5]]},"published-print":{"date-parts":[[2021,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1710025","relation":{},"ISSN":["0939-7248","1439-359X"],"issn-type":[{"value":"0939-7248","type":"print"},{"value":"1439-359X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,18]]}}}