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Case Reports

Combination of Spit Fistula Advancement and External Traction for Primary Repair of Long-Gap Esophageal Atresia

^a Department of Pediatric Surgery, University of Leipzig, Leipzig, Germany
^b Department of Pediatrics, University of Leipzig, Leipzig, Germany
^c Department of Pediatric Radiology, University of Leipzig, Leipzig, Germany
^d Department of Thoracic Surgery, University of Minnesota, Minneapolis, Minnesota

Accepted for publication May 19, 2008.

^_* Address correspondence to Dr Till, Department of Pediatric Surgery, University of Leipzig, Liebigstreet 20a, Leipzig, 04317, Germany (Email: holger.till{at}medizin.uni-leipzig.de).

Primary repair of long-gap esophageal atresia with almost complete absence of thoracic esophagus was usually believed to be impossible. Thus, esophageal replacement with colon or gastric interposition seemed inevitable. Esophageal lengthening techniques could be an alternative approach. Herewith we describe for the first time the successful combination of the stepwise subcutaneous advancement of the upper esophageal segment (Kimura's technique) with transthoracic traction on the lower esophageal segment (Foker's technique). This combined lengthening technique leads to the primary repair of a long-gap esophageal atresia.