Guidelines for treatment of esophageal atresia in the light of most recent publications.

INTRODUCTION: Esophageal atresia is a congenital anomaly well known in the community of pediatric surgeons. Nonetheless some aspects of management remain vague and societies of gastroenterologists as well as surgeons have been gathering to determine pertinent ways to handle this condition. To make ground for unification, the guidelines of some most important societies were compared and gathered in one review. MATERIALS AND METHODS: Literature review of online databases of the PubMed and the Cochrane Library with (o)esophageal atresia, guidelines and follow-up used as keywords. RESULTS: Over the course of the last few years there was a lot of effort invested in making clear and accurate guidelines for management of EA, largely with good results. In the majority of important matters, opinions of specialists were consistent or complementary to each other. Because some of them described different phases of management, gathering them together led to obtaining the wider picture, which can help pediatric surgeons in making decisions while treating the patients with EA. CONCLUSION: There is a necessity for careful following guidelines which have been changing quite fast along with new significant publications about EA. Some concerns remained debatable and their accentuation in this review was made to bring awareness to vague issues, such as postoperative antibiotic prophylaxis or duration of administering PPI. Additionally structured follow-up programs for the first 18 years and after reaching maturity should be made.

Adulthood of patients after oesophageal atresia repair- General Surgeon's Guide.

Introduction Despite proper surgical management in neonatal period, congenital oesophageal atresia [OA] may present serious source of lifelong disorders. The objective of our study is to present the most important facts about oesophageal atresia, types of treatment and possible complications which might demand surgical management in adult life. We would like to familiarize general surgeons with this matter to provide OA patients with proper medical care. Materials and Methods We made a thorough literature review of Medline database and Cochrane Library with "(o)esophageal atresia", "long gap", "surgery" and "follow-up" used as keywords. Results Long-term observation reveals that patients with OA may need help from general surgeons, however do not often look for it. Even after surgical repair in neonatal period, OA indispose to multiple concomitant disorders including gastroesophageal reflux disease, oesophagitis, strictures, epithelial metaplastic changes in the oesophagus or hiatal hernia development. Endoscopic follow-up should be systematically performed in OA patients' population in order to early detection of possible pathologies. Discussion Advancement in medicine allowed to improve survival rates and adulthood is reached more often in population of OA patients. In the face of variety of concomitant problems, systematic long-term follow-up seems to be crucial in proper medical care in these patients.