Long-gap Esophageal Atresia: Prenatal Diagnosis of Congenital Malformations

216 Pages·1986·6.097 MB·English

by  D. Booss, J. Kotlarski (auth.), Primarius Professor Dr. Peter Wurnig (eds.)

Progress in Pediatric Surgery
Volume 19
Executive Editors
W. Ch. Hecker· J. Prevot . L. Spitz
U. G. Stauffer . P. Wurnig
Senior Editor
P. P. Rickham
Editors
A. H. Bill, Seattle/USA M. Kasai, Sendai
J. Boix-Ochoa, Barcelona O. Knutrud, Oslo
C. C. Ferguson, Winnipeg J. Lister, Liverpool
R. K. Ghandi, Bombay N.A.Myers, Melbourne
S. L. Gans, Los Angeles F. Soave, Genoa t
J. A. Haller, Baltimore
Assistant Editor
T. A. Angerpointner, Munich
Long-gap
Esophageal Atresia
Prenatal Diagnosis
of Congenital Malformations
Volume Editor
P. Wurnig, Vienna
With 86 Figures
Springer-Verlag
Berlin Heidelberg New York Tokyo
Primarius Professor Dr. PETER WURNIG
Chirurgische Abteilung des
Mautner Markhof'schen Kinderspitals
der Stadt Wien
Baumgasse 75, A-I030 Wien
Volumes 1-17 of this series were published by Urban & Schwarzenberg,
Baltimore-Munich
ISBN-13 :978-3-642-70779-7 e-ISBN-13: 978-3-642-70777-3
DOl: 10.1007/978-3-642-70777-3
Library of Congress Cataloging in Publication Data. Main entry under title: Long-gap esophageal
atresia; Prenatal diagnosis of malformations. (Progress in pediatric surgery; v.19) Includes index.
1. Esophagus-Atresia-Surgery. 2. Esophagus-Atresia-Diagnosis. 3. Diagnosis, Ultrasonic.
4. Prenatal diagnosis. I. Wurnig, Peter. II. Title: Long-gap esophageal atresia. III. Title: Prenatal
diagnosis of malformations. IV. Series. [DNLM: 1. Abnormalities-diagnosis. 2. Esophageal
Atresia-surgery. 3. Prenatal Diagnosis. 4. Ultrasonic Diagnosis. WI PR677KA v.19/WI 250
L848] RD137.A1P7 vo1.19 617'.98 s [618.92'097548] 85-22171 [RJ456.E83] ISBN-13:978-
3-642-70779-7 (U.S.)
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© Springer-Verlag Berlin Heidelberg 1986
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2123/3130-543210
In Memoriam Professor Francesco Soave
Here we would like to turn our thoughts to Francesco Soave and to ex
press our deep gratitude to him.
Francesco Soave was born on June 14, 1917, in Meta di Sorrento and
died in Genoa on September 26, 1984. He was appointed surgeon in
chief at the 1. G. Gaslini Institute Hospital in 1955 and professor of
pediatric surgery at the University of Genoa in 1966, holding both posi
tions until his death. His special field was colonic and anorectal surgery,
and he often gave demonstrations and lectures on it in many countries
as a visiting or guest professor.
Professor Soave became a member of the British Association of
Paediatric Surgery in 1957 and organized its annual congress in Genoa
in 1971. He was the Windermere Foundation Travelling Professor of
Surgery in Australia in 1978 and the overseas guest speaker at the an
nual meeting of both the surgical section of the American Association
of Pediatrics (1971) and the American Pediatric Surgical Association
(1984). He held the Forshall Lecture in 1971 and the Oberniedermayr
Lecture in 1975 as a member of the Deutsche Gesellschaft fur Kinder
chirurgie.
Professor Soave served on the editorial boards of Progress in Pedi
atric Surgery, Zeitschrift fur Kinderchirurgie, and the Journal of Pedi
atric Surgery. He was president of the Societa Italian a di Pediatria from
1970 to 1972.
Innumerable international honorary presentations, awards, and
honorary memberships were devoted to him by pediatric and pediatric
surgical societies. This outstanding pediatric surgeon, teacher, and
scientist wrote more than 160 publications.
The pediatric surgery family has lost not only one of its most emi
nent members, but also a deep and cordial friend.
THOMAS A. ANGERPOINTNER/WA LDEMAR CH. HECKER, Munich
Preface
The comparison of established methods in surgery is necessary in order
to evaluate the advantages or disadvantages of each. We have therefore
tried to include discussions of all the problems which arise in the treat
ment of long-gap esophageal atresia.
The long-term results of different types of colonic interposition, of
different "stretching" procedures, and of simple staged surgery seemed
especially worthy of discussion. It was also important to describe the
role of complications caused by special pathology of the trachea in
esophageal atresia and their management.
Second, new problems continue to arise with regard to the prenatal
diagnosis of malformations. These new aspects will continue to exert an
influence on our surgical field. Malformations pose severe problems for
parents, the growing fetus, and the doctors and are lasting burdens on
our task.
PETER WURNIG, Vienna
Contents
I. Long-gap Esophageal Atresia
Current Surgical Strategies in Long-gap Esophageal Atresia with
Regard to Endoscopy Anastomosis. D. BooB and J. Kotlarski.
With 7 Figures .......................... 1
Long-gap Esophageal Atresia: Experience with Kato's Instru
mental Anastomosis, with Cervicothoracic Procedure and Pri-
mary Anastomosis, and with Retrosternal Colonic Interposition.
W. Ch. Hecker. With 6 Figures . . . . . . . . . . . . . . . . .. 9
Esophagus Replacement by Free, Autologous Jejunal Mucosa
Transplantation in Long-gap Esophageal Atresia. H. Halsband.
With 10 Figures ......................... 22
The Outcome of Colonic Replacement of the Esophagus in Chil-
dren. A. Ahmed and L. Spitz. With 3 Figures ........ 37
Gastric Tube Esophagoplasty. K. D. Anderson. With 1 Figure 55
The Significance of Tracheal Stenosis in Esophageal Atresia.
P. Wurnig, K. Mantel, W. Ch. Hecker. With 7 Figures 62
Colonic Interposition. N. V. Freeman. With 5 Figures . 73
Management of Long-gap Esophagus: Experience with End-to-
End Anastomosis Under Maximal Tension. S. Hagberg, A. Ru-
benson, U. Sillen, and K. Werkmaster. With 1 Figure . . . . .. 88
Experiences in the Treatment of Esophageal Atresia with Reh-
bein's Olive Technique. H. Sauer and R. Kurz. With 3 Figures 93
Incidence of Gastroesophageal Reflux Following Repair of Eso
phageal Atresia. A.Koch, S. Rohr, J. Plaschkes, and M. Bettex . 103
Pressure-Induced Growth (PIG) of Atretic Esophagus: A Con
tigent Management for High-Risk Esophageal Atresia. W.M.
Pieper, S.Hofman-von Kap-herr, and D.Nii-Amon-Kotei 114
Dacron-Patch Aortopexy. L. Spitz. With 2 Figures 117
Reconstruction of the Thoracic Esophagus Using Autotransplant-
ed Small Intestine - An Experimental Study in the Piglet.
G. Malmfors and L. Okmian. With 5 Figures . . . . . . . . . . . 120
x Contents
II. Prenatal Diagnosis of Congenital Malformations
Management of Prenatally Diagnosed Congenital Malformations
- Actual Problems and the Importance of an Interdisciplinary
Team Approach. U. G. Stauffer. With 5 Figures . . . . . . . .. 127
Prenatal Diagnosis of Fetal Malformations by Ultrasonography.
A. Kratochwil. With 16 Figures ................. 143
Antenatal Ultrasound Diagnosis of Congenital Malformations of
the Urinary Tract: Results and Criticism. C. A. Dell' Agnola,
U.Nicolini, G.Pistor, and G.Alzen ............... 158
Obstructive Uropathies Diagnosed in Utero. The Post Natal Out
come - A Study of 43 Cases. B. Fremond and J. M. Babut. With
7 Figures ............................. 160
Is Prenatal Ultrasonography of any Advantage? U. Schutze, W.
Schmidt, W. Maier, and G. Pfaff. With 2 Figures ........ 179
Consequences of Antenatal Diagnosis for Pediatric Surgery.
A. M. Holschneider, M. Baumgartner, and C. Mascott. With 5
Figures .............................. 185
Psychological and Ethical Problems Arising for Physicians and
Parents from the Prenatal Diagnosis of Malformations. J. Marti-
nius. With 1 Figure . . . . . . . . . . . . . . . . . . . . . . .. 197
Subject Index . . . 203
List of Editors and Contributors
Editors
Angerpointner, T. A., Dr., Kinderchirurgische Klinik im Dr. von
Haunerschen Kinderspital, LindwurmstraBe 4, D-8000 Munchen 2
Hecker, W. Ch., Prof. Dr., Kinderchirurgische Klinik im Dr. von
Haunerschen Kinderspital, LindwurmstraBe 4, D-8000 Munchen 2
Rickham, P.P., Prof. Dr. M.D., M.S., F.R.C.S., F.R.A.C.S., D.C.H.,
UniversWitskinderklinik, Chirurgische Abteilung, SteinwiesstraBe
75, CH-8032 Zurich
Prevot, J., Prof., Clinique Chirurgical Pediatrique, Hopital d'Enfants
de Nancy, F-54511 Vandrevre Cedex
Spitz, L., Prof., PhD. FRCS, Nuffield Professor of Pediatric Surgery,
Institute of Child Health, University of London, Hospital for Sick
Children, Great Ormond Street, 30 Guilford Street, GB-London
WCINlEH
Stauffer, U. G., Prof. Dr., Universitatskinderklinik, Kinderchirur
gische Abteilung, SteinwiesstraBe 75, CH-8032 Zurich
Wurnig, P., Prof. Dr., Kinderchirurgische Abteilung des Mautner
Markhof'schen Kinderspitals, Baumgasse 75, A-1030 Wien
Contributors
You will find the adresses at the beginning of the respective contribution
Ahmed, A. 37 Halsband, H. 22
Alzen, G. 158 Hecker, W.Ch. 9,62
Anderson, K.D. 55 Hofman von Kap-herr, S. 114
Babut,I.M. 160 Holschneider, A. M. 185
Baumgartner, M. 185 Koch, A. 103
Bettex, M. 103 Kotlarski, 1. 1
BooB, D. 1 Kratochwil, L. 143
Dell'Agnola, C.A. 158 Kurz, R. 93
Freeman, N. V. 73 Maier, W. 179
Fremond, B. 160 Malmfors, G. 120
Hagberg, S. 88 Mantel, K. 62
XII List of Editors and Contributors
Mascott, C. 185 Rubenson, A. 88
Martinius, J. 197 Sauer, H. 93
Nicolini, U. 158 Schmidt, W. 179
Nii-Amon-Kotei, D. 114 Schiitze, U. 179
Okmian, L. 120 Sillen, U. 88
Pfaff, G. 179 Spitz, L. 37, 117
Pieper, W.M. 114 Stauffer, U. G. 127
Pistor, G. 158 Werkmaster, K. 88
Plaschkes, J. 103 Wurnig, P. 62
Rohr, S. 103