1. Magnamosis for long gap esophageal atresia: Minimally invasive "fatal attraction".
- Author
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Conforti A, Pellegrino C, Valfré L, Iacusso C, Schingo PMS, Capolupo I, Sgro' S, Rasmussen L, and Bagolan P
- Subjects
- Infant, Humans, Magnetics, Anastomosis, Surgical methods, Treatment Outcome, Esophageal Atresia surgery, Esophageal Atresia complications, Esophageal Stenosis etiology, Digestive System Surgical Procedures adverse effects
- Abstract
Background: Aim of study is to report our preliminary experience with magnetic anastomosis (magnamosis) treating long-gap esophageal atresia (LGEA), the most challenging condition of esophageal atresia continuum. Magnamosis has been reported in 20 patients worldwide as an innovative and marginally invasive option., Methods: Prospective evaluation of all LGEA patients treated with magnamosis was performed (study registration number: 2535/2021). Main outcomes considered were demographic and surgical features, postoperative complications and feeding within 6-month of follow-up., Results: Between June 2020 and January 2021, 5 LGEA patients (Type A, Gross classification) were treated. Median preoperative gap was 5 vertebral bodies. Magnetic bullets were placed at an average age of 81 days of life, leading to successful magnamosis in all cases: 4 infants had primary magnetic repair (one after thoracoscopic mobilization of the pouches), 1 patient had a delayed magnamosis after Foker's procedure. Esophageal anastomosis was achieved after an average of 8 days. No anastomotic leak was found. All patients developed anastomotic stenosis at 6-month follow-up, requiring a mean of 6 dilations each. Full oral feeding was achieved in 3 patients, while 2 were still on oral-gastrostomy feeding. One patient experienced small esophageal perforation after dilation (3 months after magnamosis), distal to the anastomotic stricture and subsequently developed oral aversion., Conclusions: Our preliminary results suggest magnamosis a safe and effective minimally invasive option in patients with LGEA. Absence of postoperative esophageal leaks may represent a major advantage of magnamosis over conventional surgery, although possible high rate of esophageal stenosis should be further evaluated., Levels of Evidence: IV (Case series with no comparison group)., Competing Interests: Declaration of Competing Interest The Authors have no conflicts of interest to disclose None of the Authors have any conflict of interest., (Copyright © 2022. Published by Elsevier Inc.)
- Published
- 2023
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