Preface

Article Outline

• Copyright

Dr. Robert E. Gross wrote that “there has been no more dramatic advance in surgery than that which has taken place in the treatment of congenital atresia of the esophagus” (in RE Gross Surgery of Infancy and Childhood, Philadelphia, WB Saunders Company, 1953).

This issue of Seminars in Pediatric Surgery is focused on esophageal atresia and tracheoesophageal fistula. This is one of the most challenging malformations treated by Pediatric Surgeons. The survival rate of this anomaly has significantly improved during the last two decades, and this is due to advances in surgical technique, postoperative management, and treatment of complications.

In this issue of Seminars in Pediatric Surgery, Ioannides and Copp report recent data on the genes involved in the separation of respiratory and gastrointestinal tubes leading to tracheoesophageal malformations.

In 2007, a Symposium was held at the British Association of Pediatric Surgeons Annual meeting on “Controversies in esophageal atresia management.” The speakers at that symposium have all contributed to this issue of the Seminars in Pediatric Surgery. First, the repair using thoracotomy or thoracoscopy was discussed. Mortell and Azizkhan report the Cincinnati experience using thoracotomy, whereas MacKinley reports the more controversial thoracoscopic repair. During the same Symposium, the management of long-gap esophageal atresia was also discussed. Foker and coworkers describe their experience using growth induction by traction. Other authors report their experience with esophageal substitution using gastric transposition (Professor Lewis Spitz), jejunal graft (Klaas Bax), or colonic replacement (Alaa Hamza). In a separate article, Ron, De Coppi, and I report the survey of Pediatric Surgeons attending the above symposium.

The long-term outcome of esophageal atresia repair is also presented in an article by Rintala and coworkers, whereas Zani and coworkers discuss the future potential of tissue engineering of the esophagus.

The reader of this issue will have the opportunity of evaluating new data on embryology. In addition, the advantages and disadvantages of different operative techniques and the current view of surgeons dealing with this malformation are presented. To complete the assessment of this anomaly, the long-term results after esophageal atresia repair are presented as well as possible future therapeutics to construct a new esophagus.