Authors' objectives:

This study aims to assess the effects of oesophago-oesophageal anastomotic procedures in infants and older children with oesphageal atresia or stenosis, compared with other treatments.

Authors' recommendations: Oesophago-oesophageal anastomosis versus no intervention: The evidence suggests that oesophago-oesophageal anastomosis is preferable to no intervention in infants with oesophageal atresia, given that the condition is always fatal without treatment. However, paucity of data and differences in case-mix and in setting make it difficult to quantify benefits and harms. We found insufficient evidence about effects in non-infant children or in children with oesophageal stenosis. Oesophago-oesophageal anastomosis versus other surgical techniques: We found insufficient evidence to compare oesophago-oesophageal anastomosis versus other surgical techniques, either in short gap or long gap situations. Consensus opinion appears to regard oesophago-oesophageal anastomosis for short gaps as non-controversial, although opinion appears divided regarding its use for long gaps. We found insufficient evidence to support or refute these consensus positions. Foker technique for long gap atresia in infants: The sparse evidence identified on the Foker technique for long gaps suggests that it is feasible in infants with long gap atresia, and that it is preferable to no intervention. However, the safety and efficacy of the technique compared with other methods is unclear. Foker technique for stenosis in non-infant children: We found no direct evidence regarding the feasibility, safety or efficacy of the Foker technique in non-infant children or in children with oesophageal stenosis. We were unable to extrapolate effects from those seen in infant children with long gap atresia, since case series evidence is inadequate for stenosis, which has variable untreated prognosis.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.wihrd.soton.ac.uk

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: Wessex Institute for Health Research and Development

Contact Address: Pauline King. Wessex Institute for Health Research and Development, Boldrewood Medical School, Bassett Crescent East, Highfield, Southampton. SO16 7PX Tel. +44 1703 595661 Fax +44 1703 595662

Copyright: Bazian Ltd, Wessex Institute for Health Research and Development