Management of long gap esophageal atresia: A systematic review and evidence-based guidelines from the APSA Outcomes and Evidence Based Practice Committee

Robert Baird*, Dave R. Lal, Robert L. Ricca, Karen A. Diefenbach, Cynthia D. Downard, Julia Shelton, Stig Sømme, Julia Grabowski, Tolulope A. Oyetunji, Regan F. Williams, Tim Jancelewicz, Roshni Dasgupta, L. Grier Arthur, Akemi L. Kawaguchi, Yigit S. Guner, Ankush Gosain, Robert L. Gates, Juan E. Sola, Lorraine I. Kelley-Quon, Shawn D. St. PeterAdam Goldin

*Corresponding author for this work

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

Background: Treatment of the neonate with long gap esophageal atresia (LGEA) is one of the most challenging scenarios facing pediatric surgeons today. Contributing to this challenge is the variability in case definition, multiple approaches to management, and heterogeneity of the reported outcomes. This necessitates a clear summary of existing evidence and delineation of treatment controversies. Methods: The American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee drafted four consensus-based questions regarding LGEA. These questions concerned the definition and determination of LGEA, the optimal method of surgical management, expected long-term outcomes, and novel therapeutic techniques. A comprehensive search strategy was crafted and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were utilized to identify, review and report salient articles. Results: More than 3000 publications were reviewed, with 178 influencing final recommendations. In total, 18 recommendations are provided, primarily based on level 4–5 evidence. These recommendations provide detailed descriptions of the definition of LGEA, treatment techniques, outcomes and future directions of research. Conclusions: Evidence supporting best practices for LGEA is currently low quality. This review provides best recommendations based on a critical evaluation of the available literature. Based on the lack of strong evidence, prospective and comparative research is clearly needed. Type of study: Treatment study, prognosis study and study of diagnostic test. Level of evidence: Level II–V.

Original languageEnglish (US)
Pages (from-to)675-687
Number of pages13
JournalJournal of pediatric surgery
Volume54
Issue number4
DOIs
StatePublished - Apr 2019

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Esophageal Atresia
Evidence-Based Practice
Guidelines
Pediatrics
Therapeutics
Practice Guidelines
Research
Routine Diagnostic Tests
Publications
Meta-Analysis
Newborn Infant

Keywords

  • Esophageal atresia
  • Esophageal substitution
  • Long gap esophageal atresia

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Baird, Robert ; Lal, Dave R. ; Ricca, Robert L. ; Diefenbach, Karen A. ; Downard, Cynthia D. ; Shelton, Julia ; Sømme, Stig ; Grabowski, Julia ; Oyetunji, Tolulope A. ; Williams, Regan F. ; Jancelewicz, Tim ; Dasgupta, Roshni ; Arthur, L. Grier ; Kawaguchi, Akemi L. ; Guner, Yigit S. ; Gosain, Ankush ; Gates, Robert L. ; Sola, Juan E. ; Kelley-Quon, Lorraine I. ; St. Peter, Shawn D. ; Goldin, Adam. / Management of long gap esophageal atresia : A systematic review and evidence-based guidelines from the APSA Outcomes and Evidence Based Practice Committee. In: Journal of pediatric surgery. 2019 ; Vol. 54, No. 4. pp. 675-687.
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title = "Management of long gap esophageal atresia: A systematic review and evidence-based guidelines from the APSA Outcomes and Evidence Based Practice Committee",
abstract = "Background: Treatment of the neonate with long gap esophageal atresia (LGEA) is one of the most challenging scenarios facing pediatric surgeons today. Contributing to this challenge is the variability in case definition, multiple approaches to management, and heterogeneity of the reported outcomes. This necessitates a clear summary of existing evidence and delineation of treatment controversies. Methods: The American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee drafted four consensus-based questions regarding LGEA. These questions concerned the definition and determination of LGEA, the optimal method of surgical management, expected long-term outcomes, and novel therapeutic techniques. A comprehensive search strategy was crafted and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were utilized to identify, review and report salient articles. Results: More than 3000 publications were reviewed, with 178 influencing final recommendations. In total, 18 recommendations are provided, primarily based on level 4–5 evidence. These recommendations provide detailed descriptions of the definition of LGEA, treatment techniques, outcomes and future directions of research. Conclusions: Evidence supporting best practices for LGEA is currently low quality. This review provides best recommendations based on a critical evaluation of the available literature. Based on the lack of strong evidence, prospective and comparative research is clearly needed. Type of study: Treatment study, prognosis study and study of diagnostic test. Level of evidence: Level II–V.",
keywords = "Esophageal atresia, Esophageal substitution, Long gap esophageal atresia",
author = "Robert Baird and Lal, {Dave R.} and Ricca, {Robert L.} and Diefenbach, {Karen A.} and Downard, {Cynthia D.} and Julia Shelton and Stig S{\o}mme and Julia Grabowski and Oyetunji, {Tolulope A.} and Williams, {Regan F.} and Tim Jancelewicz and Roshni Dasgupta and Arthur, {L. Grier} and Kawaguchi, {Akemi L.} and Guner, {Yigit S.} and Ankush Gosain and Gates, {Robert L.} and Sola, {Juan E.} and Kelley-Quon, {Lorraine I.} and {St. Peter}, {Shawn D.} and Adam Goldin",
year = "2019",
month = "4",
doi = "10.1016/j.jpedsurg.2018.12.019",
language = "English (US)",
volume = "54",
pages = "675--687",
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Baird, R, Lal, DR, Ricca, RL, Diefenbach, KA, Downard, CD, Shelton, J, Sømme, S, Grabowski, J, Oyetunji, TA, Williams, RF, Jancelewicz, T, Dasgupta, R, Arthur, LG, Kawaguchi, AL, Guner, YS, Gosain, A, Gates, RL, Sola, JE, Kelley-Quon, LI, St. Peter, SD & Goldin, A 2019, 'Management of long gap esophageal atresia: A systematic review and evidence-based guidelines from the APSA Outcomes and Evidence Based Practice Committee', Journal of pediatric surgery, vol. 54, no. 4, pp. 675-687. https://doi.org/10.1016/j.jpedsurg.2018.12.019

Management of long gap esophageal atresia : A systematic review and evidence-based guidelines from the APSA Outcomes and Evidence Based Practice Committee. / Baird, Robert; Lal, Dave R.; Ricca, Robert L.; Diefenbach, Karen A.; Downard, Cynthia D.; Shelton, Julia; Sømme, Stig; Grabowski, Julia; Oyetunji, Tolulope A.; Williams, Regan F.; Jancelewicz, Tim; Dasgupta, Roshni; Arthur, L. Grier; Kawaguchi, Akemi L.; Guner, Yigit S.; Gosain, Ankush; Gates, Robert L.; Sola, Juan E.; Kelley-Quon, Lorraine I.; St. Peter, Shawn D.; Goldin, Adam.

In: Journal of pediatric surgery, Vol. 54, No. 4, 04.2019, p. 675-687.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Management of long gap esophageal atresia

T2 - A systematic review and evidence-based guidelines from the APSA Outcomes and Evidence Based Practice Committee

AU - Baird, Robert

AU - Lal, Dave R.

AU - Ricca, Robert L.

AU - Diefenbach, Karen A.

AU - Downard, Cynthia D.

AU - Shelton, Julia

AU - Sømme, Stig

AU - Grabowski, Julia

AU - Oyetunji, Tolulope A.

AU - Williams, Regan F.

AU - Jancelewicz, Tim

AU - Dasgupta, Roshni

AU - Arthur, L. Grier

AU - Kawaguchi, Akemi L.

AU - Guner, Yigit S.

AU - Gosain, Ankush

AU - Gates, Robert L.

AU - Sola, Juan E.

AU - Kelley-Quon, Lorraine I.

AU - St. Peter, Shawn D.

AU - Goldin, Adam

PY - 2019/4

Y1 - 2019/4

N2 - Background: Treatment of the neonate with long gap esophageal atresia (LGEA) is one of the most challenging scenarios facing pediatric surgeons today. Contributing to this challenge is the variability in case definition, multiple approaches to management, and heterogeneity of the reported outcomes. This necessitates a clear summary of existing evidence and delineation of treatment controversies. Methods: The American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee drafted four consensus-based questions regarding LGEA. These questions concerned the definition and determination of LGEA, the optimal method of surgical management, expected long-term outcomes, and novel therapeutic techniques. A comprehensive search strategy was crafted and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were utilized to identify, review and report salient articles. Results: More than 3000 publications were reviewed, with 178 influencing final recommendations. In total, 18 recommendations are provided, primarily based on level 4–5 evidence. These recommendations provide detailed descriptions of the definition of LGEA, treatment techniques, outcomes and future directions of research. Conclusions: Evidence supporting best practices for LGEA is currently low quality. This review provides best recommendations based on a critical evaluation of the available literature. Based on the lack of strong evidence, prospective and comparative research is clearly needed. Type of study: Treatment study, prognosis study and study of diagnostic test. Level of evidence: Level II–V.

AB - Background: Treatment of the neonate with long gap esophageal atresia (LGEA) is one of the most challenging scenarios facing pediatric surgeons today. Contributing to this challenge is the variability in case definition, multiple approaches to management, and heterogeneity of the reported outcomes. This necessitates a clear summary of existing evidence and delineation of treatment controversies. Methods: The American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee drafted four consensus-based questions regarding LGEA. These questions concerned the definition and determination of LGEA, the optimal method of surgical management, expected long-term outcomes, and novel therapeutic techniques. A comprehensive search strategy was crafted and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were utilized to identify, review and report salient articles. Results: More than 3000 publications were reviewed, with 178 influencing final recommendations. In total, 18 recommendations are provided, primarily based on level 4–5 evidence. These recommendations provide detailed descriptions of the definition of LGEA, treatment techniques, outcomes and future directions of research. Conclusions: Evidence supporting best practices for LGEA is currently low quality. This review provides best recommendations based on a critical evaluation of the available literature. Based on the lack of strong evidence, prospective and comparative research is clearly needed. Type of study: Treatment study, prognosis study and study of diagnostic test. Level of evidence: Level II–V.

KW - Esophageal atresia

KW - Esophageal substitution

KW - Long gap esophageal atresia

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U2 - 10.1016/j.jpedsurg.2018.12.019

DO - 10.1016/j.jpedsurg.2018.12.019

M3 - Review article

C2 - 30853248

AN - SCOPUS:85062469019

VL - 54

SP - 675

EP - 687

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

SN - 0022-3468

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