Individualized Management for Long Gap Esophageal Atresia
Palabras clave
Abstracto
Descripción
Patients with diagnosis of LGEA(gap distance>3.5cm) will be accepted to the program.
After accepted to our center, the patients will feed by gastrostomy tube to keep nutritional status remain well controlled. Continuous suction in the upper pouch will be applied to avoid aspiration pneumonia.
We will design a bouginage with baroreceptor. Then the stress function will be performed as following steps. The designed bouginage will be inserted into the upper esophagus pouch through oral cavity with a certain downward longitudinal force to increase esophageal length by tissue stretch and growth, it will be performed 10-15 minutes each time once/twice a day. While the elongation of distal pouch will be achieved via the gastrostomy using the same bouginage to give upward pressure, the program will be operated under X-ray firstly to avoid injury or false passage formation,it can be performed in the ward thereafter. The gap length and the diameter of the pouch will be evaluated every 1-2 weeks. During the elongation period, continuous upper pouch suctioning and nutritional support were maintained.
When the gap distance is short enough，the method of surgery will be decided，including end-to-end anastomosis、Livadites、flip-flap and choice of thoracoscopy use. The purpose of the program is to achieve the exact management and treatment for patients with LGEA and help promoting the use of the new technology.
fechas
| Verificado por última vez: | 09/30/2016 |
| Primero enviado: | 10/25/2016 |
| Inscripción estimada enviada: | 01/12/2017 |
| Publicado por primera vez: | 01/17/2017 |
| Última actualización enviada: | 01/12/2017 |
| Última actualización publicada: | 01/17/2017 |
| Fecha de inicio real del estudio: | 12/31/2016 |
| Fecha estimada de finalización primaria: | 09/30/2019 |
| Fecha estimada de finalización del estudio: | 09/30/2019 |
Condición o enfermedad
Intervención / tratamiento
Procedure: Staged stress function
Fase
Grupos de brazos
| Brazo | Intervención / tratamiento |
|---|---|
| Experimental: Staged stress function A preoperative staged stress function procedure for elongation of the proximal and distal segments to achieve utilizing the native esophagus to establish esophageal continuity | Procedure: Staged stress function A preoperative staged stress function procedure for elongation of the proximal and distal segments to achieve utilizing the native esophagus to establish esophageal continuity |
Criterio de elegibilidad
| Sexos elegibles para estudiar | All |
| Acepta voluntarios saludables | si |
| Criterios | Inclusion Criteria： - Patients with long gap esophageal atresia（LGEA）which the gap lenth≥3.5cm； - with（out）tracheoesophageal fistula（TEF） Exclusion Criteria: - Patients with LGEA which can not accept the staged stress function |
Salir
Medidas de resultado primarias
1. Number of patients with LGEA cured by the elongation method [up to 3 years]
Medidas de resultado secundarias
1. Data collection of patients with LGEA [up to 3 years]
