Standard treatment of infants with "wide gap" esophageal atresia usually requires a staged procedure consisting of gastrostomy at birth (with or without cervical esophagostomy) and then a bowel interposition between the oesophagus and stomach at 1 year of age. Because this approach procedures significant morbidity and swallowing dysfunction, an alternative method for treating the wide gap atresia is recommended. The upper and lower esophageal pouch can be elongated by preoperative bougienage. This technique allows successful primary esophageal reconstruction in infants with wide gap esophageal atresia previously considered uncorrectable except by use of colonic or gastric tube interpositions.
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