{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T01:44:20Z","timestamp":1782956660498,"version":"3.54.5"},"reference-count":31,"publisher":null,"issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The objectives of this study were to bring out the results of application of pleural wrap in primary repair of tracheo - esophageal fistula (TEF) with long-gap oesophageal atresia (LGEA) and also define the role of neonatologists and paediatric intensivists in post-operative management in these patients by laying down standard neonatal management protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This was a retrospective descriptive observational study conducted between March 2011 and April 2019 on 23 cases of LGEA with TEF. The study was conducted at two tertiary care paediatric surgery centres in Northern part of India wherein these newborn babies were operated by two paediatric surgeons with variable experience of 8\u201312 years. It also describes the neonatal management protocol used in post-operative period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Out of 23 patients, 15 were boys and 8 were girls, with a mean age of 32.25 weeks and a mean birth weight of 2.02 kg. The mean hospital stay was 23.5 \u00b1 8 days. Eleven cases had gap between 3 and 3.5 cm, 8 cases between 3.5 and 4 cm and 4 cases had gap more than 4 cm. The incidence of associated anomalies was 52%. Anastomotic leak rate was 8.69%, and 3 (13.04%) patients died in the post-operative period. All the operated patients were managed postoperatively as per strict neonatal management protocol exclusively by the team of neonatologists and neonatal intensivists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Application of pleural wrap over anastomosis following primary repair of LGEA with TEF significantly reduced the incidence of anastomotic leak in our study. Apart from the pleural wrap, the key to successful outcome also is contributed by the little prolonged, controlled ventilation and patience and perseverance in post-operative feeds. This post-operative management protocol that has been followed by us in our study is easily reproducible and can be adopted by paediatric surgeons working alongside neonatologists as a team.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ajps.ajps_148_22","type":"journal-article","created":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T05:00:12Z","timestamp":1726462812000},"page":"247-253","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Critical Role of Pleural Wrap and Post-operative Neonatal Protocol in Long-gap Oesophageal Atresia: A Team Effort"],"prefix":"10.67481","volume":"21","author":[{"given":"Sanat Kumar","family":"Khanna","sequence":"first","affiliation":[{"name":"Consultant Pediatric Surgeon, Army Hospital Research and Referral Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal Vishnu","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Consultant Pediatrics, Command Hospital, Chandi Mandir, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurjot","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Command Hospital, Chandi Mandir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav","family":"Panchal","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Military Hospital, Meerut, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":null,"published-online":{"date-parts":[[2024,9,13]]},"reference":[{"key":"R1-20240921","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/1750-1172-2-24","article-title":"Oesophageal atresia","volume":"2","author":"Spitz","year":"2007","journal-title":"Orphanet J Rare Dis"},{"key":"R2-20240921","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":"Foker","year":"1997","journal-title":"Ann Surg"},{"key":"R3-20240921","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1016\/j.jpedsurg.2013.09.003","article-title":"High incidence of catheter-associated venous thromboembolic events in patients with long gap esophageal atresia treated with the Foker process","volume":"49","author":"Bairdain","year":"2014","journal-title":"J Pediatr Surg"},{"key":"R5-20240921","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/jmg.12.1.1","article-title":"Oesophageal atresia in the South West of England","volume":"12","author":"David","year":"1975","journal-title":"J Med Genet"},{"key":"R6-20240921","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/j.jpedsurg.2007.12.001","article-title":"Long gap esophageal atresia:An Australian experience","volume":"43","author":"Al-Shanafey","year":"2008","journal-title":"J Pediatr Surg"},{"key":"R7-20240921","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1007\/s00383-007-1964-0","article-title":"Prognosis of congenital tracheoesophageal fistula with esophageal atresia on the basis of gap length","volume":"23","author":"Upadhyaya","year":"2007","journal-title":"Pediatr Surg Int"},{"key":"R8-20240921","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/S0022-3468(81)80347-8","article-title":"Delayed primary anastomosis following spontaneous growth of esophageal segments in esophageal atresia","volume":"16","author":"Puri","year":"1981","journal-title":"J Pediatr Surg"},{"key":"R9-20240921","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1053\/jpsu.2002.36176","article-title":"An exclusively intraabdominal distal esophageal segment prevents primary delayed anastomosis in children with pure esophageal atresia","volume":"37","author":"Maksoud-Filho","year":"2002","journal-title":"J Pediatr Surg"},{"key":"R10-20240921","doi-asserted-by":"crossref","first-page":"1542","DOI":"10.1016\/j.jpedsurg.2005.06.007","article-title":"The management of long gap esophageal atresia","volume":"40","author":"S\u00e9guier-Lipszyc","year":"2005","journal-title":"J Pediatr Surg"},{"key":"R11-20240921","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/BF00178421","article-title":"The reversed gastric tube for esophageal replacement in children","volume":"11","author":"Randolph","year":"1996","journal-title":"Pediatr Surg Int"},{"key":"R12-20240921","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1007\/BF00178423","article-title":"Oesophageal substitution by jejunal free graft:Follow-up data and an evaluation","volume":"11","author":"Spicer","year":"1996","journal-title":"Pediatr Surg Int"},{"key":"R13-20240921","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1007\/BF00179446","article-title":"Early one-stage orthotopic jejunal pedicle-graft interposition in long-gap esophageal atresia","volume":"9","author":"Bax","year":"1994","journal-title":"Pediatr Surg Int"},{"key":"R14-20240921","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/S0022-3468(88)80454-8","article-title":"Long-term results of jejunal replacement of the esophagus","volume":"23","author":"Saeki","year":"1988","journal-title":"J Pediatr Surg"},{"key":"R15-20240921","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1016\/S0022-3468(96)90078-0","article-title":"Esophageal replacement using the colon:Is it a good choice?","volume":"31","author":"Ahmad","year":"1996","journal-title":"J Pediatr Surg"},{"key":"R16-20240921","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1016\/S0022-3468(96)90165-7","article-title":"Experience with distal circular myotomy for long-gap esophageal atresia","volume":"31","author":"Lai","year":"1996","journal-title":"J Pediatr Surg"},{"key":"R17-20240921","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1053\/jpsu.2001.23953","article-title":"Circular myotomy of the distal esophageal stump for long gap esophageal atresia","volume":"36","author":"Giacomoni","year":"2001","journal-title":"J Pediatr Surg"},{"key":"R18-20240921","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1016\/j.jpedsurg.2004.03.048","article-title":"Long gap esophageal atresia and esophageal replacement:Moving toward a separation?","volume":"39","author":"Bagolan","year":"2004","journal-title":"J Pediatr Surg"},{"key":"R20-20240921","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/S0022-3468(78)80453-9","article-title":"The value of circular myotomy for esophageal atresia","volume":"13","author":"Vizas","year":"1978","journal-title":"J Pediatr Surg"},{"key":"R21-20240921","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/S0022-3468(87)80421-9","article-title":"Livaditis myotomy in long-gap esophageal atresia","volume":"22","author":"Lindahl","year":"1987","journal-title":"J Pediatr Surg"},{"key":"R22-20240921","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/S0022-5223(19)38016-X","article-title":"Long gap esophageal atresia:Primary anastomosis after esophageal elongation by bougienage and esophagomyotomy","volume":"79","author":"de","year":"1980","journal-title":"J Thorac Cardiovasc Surg"},{"key":"R23-20240921","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/0022-3468(92)90098-R","article-title":"Anastomotic leakage following surgery for esophageal atresia","volume":"27","author":"Chittmittrapap","year":"1992","journal-title":"J Pediatr Surg"},{"key":"R27-20240921","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1053\/j.semtcvs.2006.11.001","article-title":"Management of the cervical esophagogastric anastomotic stricture","volume":"19","author":"Chang","year":"2007","journal-title":"Semin Thorac Cardiovasc Surg"},{"key":"R28-20240921","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":"Sill\u00e9n","year":"1988","journal-title":"J Pediatr Surg"},{"key":"R29-20240921","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1007\/978-3-642-70777-3_8","article-title":"Management of long-gap esophagus:Experience with end-to-end anastomosis under maximal tension","volume":"19","author":"Hagberg","year":"1986","journal-title":"Prog Pediatr Surg"},{"key":"R30-20240921","doi-asserted-by":"crossref","first-page":"50","DOI":"10.4103\/0971-9261.78130","article-title":"Esophageal atresia and tracheoesophageal fistula:Effect of pleural cover on anastomotic dehiscence","volume":"16","author":"Gupta","year":"2011","journal-title":"J Indian Assoc Pediatr Surg"},{"key":"R31-20240921","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":"McKinnon","year":"1990","journal-title":"J Pediatr Surg"},{"key":"R32-20240921","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1590\/S0102-67202015000300003","article-title":"Evaluation of risk factors affecting anastomotic leakage after repair of esophageal atresia","volume":"28","author":"Askarpour","year":"2015","journal-title":"Arq Bras Cir Dig"},{"key":"R33-20240921","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1590\/S0041-87811999000100003","article-title":"Effects of circular myotomy on the healing of esophageal suture anastomosis:An experimental study","volume":"54","author":"Tannuri","year":"1999","journal-title":"Rev Hosp Clin Fac Med Sao Paulo"},{"key":"R34-20240921","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1016\/0003-4975(94)90548-7","article-title":"Primary repair of ultra-long-gap esophageal atresia:Results without a lengthening procedure","volume":"57","author":"Boyle","year":"1994","journal-title":"Ann Thorac Surg"},{"key":"R35-20240921","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1016\/j.jpedsurg.2014.02.052","article-title":"Post-operative management of esophageal atresia-tracheoesophageal fistula and gastroesophageal reflux:A Canadian association of pediatric surgeons annual meeting survey","volume":"49","author":"Shawyer","year":"2014","journal-title":"J Pediatr Surg"},{"key":"R36-20240921","first-page":"e11904","article-title":"Management of early post-operative complications of esophageal atresia with tracheoesophageal fistula:A retrospective study","volume":"12","author":"Syed","year":"2020","journal-title":"Cureus"}],"container-title":["African Journal of Paediatric Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.4103\/ajps.ajps_148_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:49:42Z","timestamp":1782953382000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.4103\/ajps.ajps_148_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,13]]},"references-count":31,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/ajps.ajps_148_22","relation":{},"ISSN":["0189-6725","0974-5998"],"issn-type":[{"value":"0189-6725","type":"print"},{"value":"0974-5998","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,13]]},"assertion":[{"value":"2022-11-04","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-07","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}