Eur J Pediatr Surg 2020; 30(06): 475-482
DOI: 10.1055/s-0039-3400284
Review Article

ERNICA Consensus Conference on the Management of Patients with Esophageal Atresia and Tracheoesophageal Fistula: Follow-up and Framework

Carmen Dingemann
1   Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany
,
Simon Eaton
2   Department of Paediatric Surgery & Metabolic Biochemistry, UCL Great Ormond Street Institute of Child Health, University College London Institute of Child Health, London, United Kingdom
,
Gunnar Aksnes
3   Department of Pediatric Surgery, Oslo University Hospital, Oslo, Norway
,
Pietro Bagolan
4   Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital-Research Institute, Rome, Italy
,
Kate M. Cross
5   Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital for Children, London, United Kingdom
,
Paolo De Coppi
5   Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital for Children, London, United Kingdom
6   Department of Paediatric Surgery & Metabolic Biochemistry, UCL Great Ormond Street Institute of Child Health Library, London, United Kingdom
,
JoAnne Fruithof
7   Esophageal Atresia and Tracheo-Esophageal Fistula Support Federation & - VOKS, Lichtenvoorde, The Netherlands
,
Piergiorgio Gamba
8   Department of Pediatric Surgery, University of Padua, Padua, Italy
,
Steffen Husby
9   Department of Pediatric Gastroenterology, Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
,
Antti Koivusalo
10   Department of Pediatric Surgery, University of Helsinki, Helsinki, Finland
,
Lars Rasmussen
11   Department of Pediatric Surgery, Odense University Hospital, Odense, Denmark
,
Rony Sfeir
12   Department of Pediatric Surgery CRACMO, Centre Hospitalier Régional Universitaire de Lille, Lille, France
,
Graham Slater
13   Esophageal Atresia and Tracheo-Esophageal Fistula Support Federation & - TOFS, Nottingham, United Kingdom
,
Jan F. Svensson
14   Department of Pediatric Surgery, Karolinska University Hospital, Stockholm, Sweden
,
David C. Van der Zee
15   Department of Pediatric Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
,
Lucas M. Wessel
16   Department of Pediatric Surgery, University of Mannheim, Medical Faculty of Heidelberg, Mannheim, Germany
,
Anke Widenmann-Grolig
17   Esophageal Atresia and Tracheo-Esophageal Fistula Support Federation & - KEKS, Stuttgart, Germany
,
Rene Wijnen
18   Department of Pediatric Surgery, Erasmus MC Rotterdam, Rotterdam, The Netherlands
,
Benno M. Ure
1   Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany
› Institutsangaben

Abstract

Introduction Improvements in care of patients with esophageal atresia (EA) and tracheoesophageal fistula (TEF) have shifted the focus from mortality to morbidity and quality-of-life. Long-term follow-up is essential, but evidence is limited and standardized protocols are scarce. Nineteen representatives of the European Reference Network for Rare Inherited Congenital Anomalies (ERNICA) from nine European countries conducted a consensus conference on the surgical management of EA/TEF.

Materials and Methods The conference was prepared by item generation (including items of surgical relevance from the European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN)-The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) guidelines on follow-up after EA repair), item prioritization, formulation of a final list containing the domains Follow-up and Framework, and literature review. Anonymous voting was conducted via an internet-based system. Consensus was defined as ≥75% of those voting with scores of 6 to 9.

Results Twenty-five items were generated in the domain Follow-up of which 17 (68%) matched with corresponding ESPGHAN-NASPGHAN statements. Complete consensus (100%) was achieved on seven items (28%), such as the necessity of an interdisciplinary follow-up program. Consensus ≥75% was achieved on 18 items (72%), such as potential indications for fundoplication. There was an 82% concordance with the ESPGHAN-NASPGHAN recommendations. Four items were generated in the domain Framework, and complete consensus was achieved on all these items.

Conclusion Participants of the first ERNICA conference reached significant consensus on the follow-up of patients with EA/TEF who undergo primary anastomosis. Fundamental statements regarding centralization, multidisciplinary approach, and involvement of patient organizations were formulated. These consensus statements will provide the cornerstone for uniform treatment protocols and resultant optimized patient care.

Supplementary Material



Publikationsverlauf

Eingereicht: 05. September 2019

Angenommen: 04. Oktober 2019

Artikel online veröffentlicht:
27. November 2019

© 2020. Thieme. All rights reserved.

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Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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