Endoscopic Ultrasound Findings in Esophageal Atresia Following Surgical Repair
Study Details
Study Description
Brief Summary
Children with esophageal atresia who undergo surgical repair are at risk for anastomotic stricture following surgery. Esophageal stricture can be treated with serial endoscopic dilation but may ultimately need surgical resection if the stricture proves refractory to therapy. Several risk factors have been reported for development of recalcitrant stricture, but to date, no studies have specifically examined the relationship between anastomotic thickness and echotexture at time of initial postoperative endoscopy and treatment outcomes. Other risk factors that have been implicated in the development of recalcitrant stricture include gastroesophageal reflux disease, anastomotic leak, long-gap esophageal atresia, and gestational age. Moreover, it is poorly understood how esophageal layers alter and progress with repeated therapeutic dilation. The investigator hypothesize that the initial thickness and echotexture will help determine therapeutic outcome. It will also help us understand the progression of esophageal echotexture following therapeutic dilation.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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N/A |
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Patients with esophageal stricture following surgical repair Patients with esophageal atresia following surgical repair who developed an esophageal stricture |
Device: Pediatric endoscopic ultrasound
endoscopic ultrasound at the esophageal stricture site to assess echo texture and esophageal layers
|
Outcome Measures
Primary Outcome Measures
- Predict post surgical primary repair outcome in patients with esophageal atresia using endoscopic ultrasound [2 years]
Patients with esophageal atresia following surgical repair will undergo an endoscopic ultrasound procedure to measure esophageal layer thickness and to describe esophageal echo-texture characteristics at the anastomotic site
Eligibility Criteria
Criteria
Inclusion Criteria:
- Patients ages 0-21 years old at time of evaluation with a suspected diagnosis of esophageal stricture secondary to esophageal atresia (with or without Tracheoesophageal fistula) post surgical repair
Exclusion Criteria:
-
Patients with pre-diagnosis of eosinophilic esophagitis
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Patients with pre-diagnosis of congenital esophageal stricture
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Patients diagnosed with esophageal stricture secondary to caustic ingestion
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Patient is diagnosed with an esophageal perforation at time of endoscopy
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Boston Children's Hospital
Investigators
- Principal Investigator: michael manfredi, MD, Boston Children's Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
- Amae S, Nio M, Kamiyama T, Ishii T, Yoshida S, Hayashi Y, Ohi R. Clinical characteristics and management of congenital esophageal stenosis: a report on 14 cases. J Pediatr Surg. 2003 Apr;38(4):565-70. Review.
- Kouchi K, Yoshida H, Matsunaga T, Ohtsuka Y, Nagatake E, Satoh Y, Terui K, Mitsunaga T, Ochiai T, Arima M, Ohnuma N. Endosonographic evaluation in two children with esophageal stenosis. J Pediatr Surg. 2002 Jun;37(6):934-6.
- IRB-P00032913