Abstract
The multistaged extrathoracic esophageal elongation procedure is useful for preserving the native esophagus in long-gap esophageal atresia. However, this technique requires repeated meticulous dissection of the proximal esophagus to prevent injury to the esophageal wall and cervical nerves and vessels. Herein we report a case of type A esophageal atresia using Seprafilm adhesion barrier in a multistaged extrathoracic elongation procedure. A female baby was born at 36 weeks' gestation weighing 2,612g. A gastrostomy was performed at the age of 2 days on the diagnosis of esophageal atresia without tracheoesophageal fistula. At the age of 2 months, the cervical esophagostomy was fashioned while placing Seprafilm around the cervical esophagus as well as subsequent elongation procedures, starting "sham-feeding". Initial elongation was performed at the age of 5 months with 2.5cm elongation. Further elongation was performed at the age of 9 months and 14 months with 1.5cm and 1.8cm elongation respectively. The proximal esophagus was covered with a Penrose drain to pass through the subcutaneous tunnel to avoid infection. The adhesion around the cervical esophagus was sparse; thus it was not necessary to incise the previous scar to dissect the proximal esophagus extended to the level of the cricoid cartilage in both elongation procedures and the definitive operation, which was performed at the age of 18 months with tension-free end-to-end anastomosis.
