{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:32:53Z","timestamp":1787758373405,"version":"build-2784847793"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Following esophageal atresia\/tracheoesophageal fistula (EA\/TEF) repair, the standard leak rate reported in the literature is 5%\u201310%, and stricture rate is 40%\u201372%. There is a global quest for surgical innovations to drive down these complication rates which can cause considerable morbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A prospectively maintained database of the senior author's patients who had esophageal atresia repair from 1995 to 2016 was reviewed. Two distinct innovations were implemented: (1) adequate or generous mobilization of the lower esophageal pouch and (2) a 2\u20135 mm slit in distal esophagus to widen its circumference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Forty-three patients with EA\/TEF were reviewed. Of those, 40 underwent primary repair. The median follow-up was 12.5 years (range 4\u201326 years). There were no anastomotic leaks and only 8 (20%) patients developed anastomotic strictures requiring dilations (1\u20135 dilations\/patients). One patient (2.5%) had a recurrent fistula. One early mortality was recorded. At the latest follow-up, 35 (87.5%) patients had normal oral feeding, while 1 (2.5%) patient had occasional food sticking episodes. Four syndromic patients (10%) were on jejunal or gastrostomy feeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>An adequate or generous mobilization of the distal esophageal pouch, together with a 2\u20135 mm slit in the distal esophagus, achieves a tension-free and wide anastomosis. All anastomoses eventually narrow, sometimes just a little, and starting on a higher scale with a small slit, helps. These seemingly minor innovations, when used together, contributed to a substantially lower complication rate sustained over a 22-year period \u2013 no leaks and only 20% stricture rate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jiaps.jiaps_61_22","type":"journal-article","created":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T23:28:42Z","timestamp":1668122922000},"page":"728-734","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":26,"title":["Technical Innovations to Reduce Complication Rates in Esophageal Atresia with Particular Reference to Long-term 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