Facharzt FMH Kinderchirurgie Practice Questions - Facharzt FMH Für Kinderchirurgie Spécialiste FMH En Chirurgie Pédiatrique Exam

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A newborn is diagnosed with isolated pure esophageal atresia without tracheoesophageal fistula (Gross Type A). Plain radiography shows a coiled Replogle catheter in the upper mediastinum and a completely gasless, scaphoid abdomen. Fluoroscopic and endoscopic assessment reveals an esophageal gap of 4 vertebral bodies (long-gap esophageal atresia). What is the contemporary evidence-based primary management strategy to achieve native esophageal preservation before contemplating stomach or colon interposition?

Immediate emergency cervical esophagostomy (spit fistula) and permanent Roux-en-Y jejunal transposition within 48 hours of birth Urgent high-tension primary end-to-end anastomosis over a rigid metal bougie at 24 hours of life Transdiaphragmatic gastric transposition (gastric pull-up) performed during the first week of life Placement of a feeding gastrostomy with continuous upper pouch suction, allowing spontaneous somatic elongation and delayed primary anastomosis at 2–3 months (or staged dynamic traction via the Foker technique)

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Placement of a feeding gastrostomy with continuous upper pouch suction, allowing spontaneous somatic elongation and delayed primary anastomosis at 2–3 months (or staged dynamic traction via the Foker technique)

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