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Overview

At Boston Children's Hospital, we're known for our science-driven approach. In fact, we're home to the world's most extensive pediatric hospital research enterprise. We also partner with elite healthcare and biotech organizations around the globe.

Providing groundbreaking treatment for long-gap esophageal atresia

Until recently, esophageal atresia (EA) was a condition with no truly satisfactory treatment options. For a child with long-gap esophageal atresia, the gap between the two "nubs" of the esophagus is too far apart to connect surgically, even with transplanted tissue. The Foker process is a revolutionary procedure that encourages natural growth and strengthening of a child's existing esophagus, resulting in an esophagus that works so well that is it nearly indistinguishable from one that developed normally. We have the most extensive experience in the world in performing the Foker process, with outcomes data to support its benefits.

Key findings by the EAT Center team

  • The Foker process is significantly more effective when used as a first-line treatment for long-gap esophageal atresia compared with secondary long-gap esophageal atresia that has been previously treated elsewhere.
  • Posterior tracheopexy is effective in treating severe tracheomalacia with significant improvements in clinical symptoms and degree of airway collapse on bronchoscopy.
  • A 2016 retrospective review of 66 patients with postoperative recurrent and acquired TEF following esophageal atresia repair is the largest such series to date and provides a new categorization for postoperative TEF that helps clarify the diagnostic and therapeutic challenges for management.
  • Our outcomes demonstrate that the jejunum can be used as an esophageal graft even in very difficult cases with failed multiple earlier operations for correction of EA/TEF. These results contribute important information to the choice of interposition graft and the early treatment of complex patients.
  • Slide esophagoplasty may be a useful technique of anastomotic configuration for selected patients with recalcitrant esophageal stricture, offering more favorable outcomes compared with end-to-end anastomosis.
  • Esophageal dilation with balloon or savory dilators are equally safe and effective for the treatment of anastomotic strictures associated with esophageal atresia.