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2. Author Correction: Oesophageal atresia

Author

van Lennep, Marinde, Singendonk, Maartje M. J., Dall’Oglio, Luigi, Gottrand, Fréderic, Krishnan, Usha, Terheggen-Lagro, Suzanne W. J., Omari, Taher I., Benninga, Marc A., and van Wijk, Michiel P.

Published
2024
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3. The International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia–tracheoesophageal fistula

Author

Krishnan, Usha, Dumont, Michael W., Slater, Hayley, Gold, Benjamin D., Seguy, David, Bouin, Mikael, Wijnen, Rene, Dall’Oglio, Luigi, Costantini, Mario, Koumbourlis, Anastassios C., Kovesi, Thomas A., Rutter, Michael J., Soma, Marlene, Menzies, Jessica, Van Malleghem, Audrey, Rommel, Nathalie, Dellenmark-Blom, Michaela, Wallace, Vuokko, Culnane, Evelyn, Slater, Graham, Gottrand, Frederic, and Faure, Christophe

Published
2023
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4. Multi-disciplinary Insights from the First European Forum on Visceral Myopathy 2022 Meeting

Author

Viti, Federica, De Giorgio, Roberto, Ceccherini, Isabella, Ahluwalia, Arti, Alves, Maria M., Baldo, Chiara, Baldussi, Giannina, Bonora, Elena, Borrelli, Osvaldo, Dall’Oglio, Luigi, De Coppi, Paolo, De Filippo, Carlotta, de Santa Barbara, Pascal, Diamanti, Antonella, Di Lorenzo, Carlo, Di Maulo, Ruggero, Galeone, Antonio, Gandullia, Paolo, Hashmi, Sohaib K., Lacaille, Florence, Lancon, Laurence, Leone, Salvatore, Mahé, Maxime M., Molnar, Maria Judit, Palmitelli, Alessandro, Perin, Silvia, Prato, Alessio Pini, Thapar, Nikhil, Vassalli, Massimo, and Heuckeroth, Robert O.

Published
2023
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6. Surgery in Motility Disorders

Author

De Angelis, Paola, Fusaro, Fabio, Balassone, Valerio, Caldaro, Tamara, Imondi, Chiara, Tambucci, Renato, Dall’Oglio, Luigi, Faure, Christophe, editor, Thapar, Nikhil, editor, and Di Lorenzo, Carlo, editor

Published
2022
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8. How to Care for Patients with EA-TEF: The Known and the Unknown

Author

Mousa, Hayat, Krishnan, Usha, Hassan, Maheen, Dall’Oglio, Luigi, Rosen, Rachel, Gottrand, Frédéric, and Faure, Christophe

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Digestive Diseases, Rare Diseases, Antacids, Eosinophilic Esophagitis, Esophageal Atresia, Esophageal Stenosis, Esophageal pH Monitoring, Gastroesophageal Reflux, Humans, Long-Term Care, Tracheoesophageal Fistula, Anastamotic strictures, Complications, Eosinophilic esophagitis, Esophageal atresia, Gastroesophageal reflux disease, Long-term follow-up, Multichannel intraluminal impedance, Review, Tracheoesophageal fistula, Oncology and carcinogenesis
Abstract

Purpose of reviewGuidelines were recently published highlighting why esophageal atresia (EA) patients are prone to complication risks, and the need for long-term follow-up. In this review, we will focus on how to investigate and treat potential complications, as well as the pros and cons of different investigative and treatment modalities, and what areas continue to need further research.Recent findingsEA patients are at high risk for gastroesophageal reflux and esophageal strictures, and the sequela that result. Extraintestinal manifestations of gastroesophageal reflux disease (GERD) can appear similar to other pathologic diagnoses commonly found in EA patients, such as congenital stricture, eosinophilic esophagitis, esophageal dysmotility, tracheomalacia, recurrent fistula, aspiration, etc. Therefore, it is important to have a standardized way to monitor for these issues. pH impedance allows for detection of nonacid reflux and the height of reflux, which are important in correlating symptoms with reflux episodes. A multidisciplinary approach is beneficial in evaluating and monitoring EA patients in the long term.

Published
2017

10. Evaluation of Gastroesophageal Reflux Disease 1 Year after Esophageal Atresia Repair: Paradigms Lost from a Single Snapshot?

Author

Tambucci, Renato, Isoldi, Sara, Angelino, Giulia, Torroni, Filippo, Faraci, Simona, Rea, Francesca, Romeo, Erminia Francesca, Caldaro, Tamara, Guerra, Luciano, Contini, Anna Chiara Iolanda, Malamisura, Monica, Federici di Abriola, Giovanni, Francalanci, Paola, Conforti, Andrea, Dall’Oglio, Luigi, and De Angelis, Paola

Published
2021
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11. Navigating global collaboration:challenges faced by the international network on esophageal atresia

Author

Gottrand, Frédéric, Krishnan, Usha, Widenmann, Anke, Blom, Michaela Dellenmark, Dall’Oglio, Luigi, Wijnen, Rene, van Wijk, Michiel, Fruithof, Jo Anne, von Allmen, Daniel, Kovesi, Tom, Faure, Christophe, Gottrand, Frédéric, Krishnan, Usha, Widenmann, Anke, Blom, Michaela Dellenmark, Dall’Oglio, Luigi, Wijnen, Rene, van Wijk, Michiel, Fruithof, Jo Anne, von Allmen, Daniel, Kovesi, Tom, and Faure, Christophe

Abstract

The International Network on Esophageal Atresia (INoEA) stands as a beacon of collaboration in addressing the complexities of this congenital condition on a global scale. The eleven board members, from various countries (USA, Canada, France, Australia, Italy, Sweden, Germany, and The Netherlands) and backgrounds (pediatric gastroenterology, pediatric surgery, pediatric pulmonology, nursing, and parents) met in a face-to-face symposium in Lille in November 2023, to identify challenges and solutions for improving global collaboration of the network.

Published
2024

14. ESPGHAN-NASPGHAN Guidelines for the Evaluation and Treatment of Gastrointestinal and Nutritional Complications in Children With Esophageal Atresia-Tracheoesophageal Fistula

Author

Krishnan, Usha, Mousa, Hayat, Dall’Oglio, Luigi, Homaira, Nusrat, Rosen, Rachel, Faure, Christophe, and Gottrand, Frédéric

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Digestive Diseases, Rare Diseases, Pediatric, Management of diseases and conditions, 7.1 Individual care needs, Oral and gastrointestinal, Adolescent, Child, Disease Management, Esophageal Atresia, Guidelines as Topic, Humans, Quality of Life, Tracheoesophageal Fistula, anastomotic stricture, dysphagia, esophageal atresia, esophageal carcinoma, guidelines, transition, Medical and Health Sciences, Gastroenterology & Hepatology, Clinical sciences, Nutrition and dietetics, Paediatrics
Abstract

BackgroundEsophageal atresia (EA) is one of the most common congenital digestive anomalies. With improvements in surgical techniques and intensive care treatments, the focus of care of these patients has shifted from mortality to morbidity and quality-of-life issues. These children face gastrointestinal (GI) problems not only in early childhood but also through adolescence and adulthood. There is, however, currently a lack of a systematic approach to the care of these patients. The GI working group of International Network on Esophageal Atresia comprises members from ESPGHAN/NASPGHAN and was charged with the task of developing uniform evidence-based guidelines for the management of GI complications in children with EA.MethodsThirty-six clinical questions addressing the diagnosis, treatment, and prognosis of the common GI complications in patients with EA were formulated. Questions on the diagnosis, and treatment of gastroesophageal reflux, management of "cyanotic spells," etiology, investigation and management of dysphagia, feeding difficulties, anastomotic strictures, congenital esophageal stenosis in EA patients were addressed. The importance of excluding eosinophilic esophagitis and associated GI anomalies in symptomatic patients with EA is discussed as is the quality of life of these patients and the importance of a systematic transition of care to adulthood. A systematic literature search was performed from inception to March 2014 using Embase, MEDLINE, the Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Clinical Trials, and PsychInfo databases. The approach of the Grading of Recommendations Assessment, Development and Evaluation was applied to evaluate outcomes. During 2 consensus meetings, all recommendations were discussed and finalized. The group members voted on each recommendation, using the nominal voting technique. Expert opinion was used where no randomized controlled trials were available to support the recommendation.

Published
2016

15. Conclusions

Author

Dall’Oglio, Luigi, Dall'Oglio, Luigi, editor, and Romano, Claudio, editor

Published
2018
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16. Gastric cancer, inflammatory bowel disease and polyautoimmunity in a 17-year-old boy: CTLA-4 deficiency successfully treated with Abatacept

Author

Angelino, Giulia, Cifaldi, Cristina, Zangari, Paola, Di Cesare, Silvia, Di Matteo, Gigliola, Chiriaco, Maria, Francalanci, Paola, Faraci, Simona, Rea, Francesca, Romeo, Erminia Francesca, Amodio, Donato, Ursu, Giorgiana Madalina, Bertocchini, Arianna, Accinni, Antonella, Crocoli, Alessandro, Inserra, Alessandro, Cozza, Raffaele, Romano, Claudio, Licciardello, Maria, Rinelli, Martina, Dall’Oglio, Luigi, Cancrini, Caterina, De Angelis, Paola, and Finocchi, Andrea

Published
2021
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19. Gastric Volvulus

Author

Caldaro, Tamara, Torroni, Filippo, Romeo, Erminia, di Abriola, Giovanni Federici, Dall’Oglio, Luigi, Till, Holger, editor, Thomson, Mike, editor, Foker, John E., editor, Holcomb III, George W., editor, and Khan, Khalid M., editor

Published
2017
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20. Esophageal Injuries and Foreign Bodies

Author

Torroni, Filippo, De Angelis, Paola, Dall’Oglio, Luigi, Till, Holger, editor, Thomson, Mike, editor, Foker, John E., editor, Holcomb III, George W., editor, and Khan, Khalid M., editor

Published
2017
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24. Approach to Endoscopic Balloon Dilatation in Pediatric Stricturing Crohn Disease: A Position Paper of the Endoscopy Special Interest Group of ESPGHAN

Author

Ledder, Oren, Homan, Matjaž, Furlano, Raoul, Papadopoulou, Alexandra, Oliva, Salvatore, Dias, Jorge Amil, Dall'Oglio, Luigi, Faraci, Simona, Narula, Priya, Schluckebier, Dominique, Hauser, Bruno, Nita, Andreia, Romano, Claudio, Tzivinikos, Christos, Bontems, Patrick, Thomson, Mike, Brussels Heritage Lab, Clinical sciences, Growth and Development, and Pediatrics

Subjects
Crohn's disease, pediatric, hepatology, Pediatrics, Perinatology and Child Health, Gastroenterology, Pediatrics, Perinatology, and Child Health, ESPGHAN, Endoscopic Balloon Dilatation
Abstract

Crohn disease (CD) is often complicated by bowel strictures that can lead to obstructive symptoms, resistant inflammation, and penetrating complications. Endoscopic balloon dilatation of CD strictures has emerged as a safe and effective technique for relieving these strictures, which may obviate the need for surgical intervention in the short and medium term. This technique appears to be underutilized in pediatric CD. This position paper of the Endoscopy Special Interest Group of European Society for Pediatric Gastroenterology, Hepatology and Nutrition describes the potential applications, appropriate evaluation, practical technique, and management of complications of this important procedure. The aim being to better integrate this therapeutic strategy in pediatric CD management.

Published
2023
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26. Short-term Psychodynamic Psychotherapy in Addition to Standard Medical Therapy Increases Clinical Remission in Adolescents and Young Adults with Inflammatory Bowel Disease: a Randomised Controlled Trial

Author

Milo, Francesco, primary, Imondi, Chiara, additional, D’Amore, Carmen, additional, Angelino, Giulia, additional, Knafelz, Daniela, additional, Bracci, Fiammetta, additional, Dall’Oglio, Luigi, additional, De Angelis, Paola, additional, and Tabarini, Paola, additional

Published
2023
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28. Short-term Psychodynamic Psychotherapy in Addition to Standard Medical Therapy Increases Clinical Remission in Adolescents and Young Adults with Inflammatory Bowel Disease: a Randomised Controlled Trial.

Author

Milo, Francesco, Imondi, Chiara, D'Amore, Carmen, Angelino, Giulia, Knafelz, Daniela, Bracci, Fiammetta, Dall'Oglio, Luigi, Angelis, Paola De, and Tabarini, Paola

Abstract

Background Inflammatory bowel diseases [IBD] are chronic and pervasive conditions of the gastrointestinal tract with a rising incidence in paediatric and young adult populations. Evidence suggests that psychological disorders might be associated with relapse of disease activity. This study aims to evaluate the efficacy of short-term psychodynamic psychotherapy [STPP] in addition to standard medical therapy [SMT] in maintaining clinical remission in adolescents and young adults [AYA] with quiescent IBD, compared with SMT alone. Methods A two-arm, single-centre, randomised, controlled trial was conducted in 60 IBD AYA in clinical remission. Patients were randomised to receive an 8-week STPP + SMT [ n  = 30] or SMT alone [ n  = 30]. The primary outcome was the steroid-free remission rate at 52 weeks after treatment. Secondary outcomes included the overall hospitalisation rate within 52 weeks after treatment, and medication adherence obtained from patient's electronic medical records. Results Intention-to-treat analysis showed significant improvement in maintaining disease remission rates in the 8-week STPP + SMT group compared with the control one. The proportion of patients maintaining steroid-free remission at 52 weeks was higher in patients in STTP group [93.1%] compared with patients randomised to control group [64.3%; p  = 0.01]. There were no significant differences in secondary outcomes, except for depression reduction in STPP + SMT group. Conclusions An 8-week STPP intervention in addition to SMT effectively increases the steroid-free remission rates in AYA with quiescent IBD. Results do not support effects for other secondary outcomes, except for depression reduction. [ABSTRACT FROM AUTHOR]

Published
2024
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29. Oral viscous budesonide in children with eosinophilic esophagitis after repaired esophagealatresia: a clinical trial.

Author

Tambucci, Renato, primary, Roversi, Marco, additional, Rea, Francesca, additional, Malamisura, Monica, additional, Angelino, Giulia, additional, Biondi, Isabella, additional, Simeoli, Raffaele, additional, Goffredo, Bianca Maria, additional, Francalanci, Paola, additional, Simonetti, Alessandra, additional, Livadiotti, Susanna, additional, Corsetti, Tiziana, additional, Dall’Oglio, Luigi, additional, Rossi, Paolo, additional, Pontrelli, Giuseppe, additional, and De Angelis, Paola, additional

Published
2023
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30. The Use of Jejunal Tube Feeding in Children: A Position Paper by the Gastroenterology and Nutrition Committees of the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition 2019

Author

Broekaert, Ilse J., Falconer, Jackie, Bronsky, Jiri, Gottrand, Frederic, Dall’Oglio, Luigi, Goto, Eunice, Hojsak, Iva, Hulst, Jessie, Kochavi, Brigitte, Papadopoulou, Alexandra, Ribes-Koninckx, Carmen, Schaeppi, Michela, Werlin, Steven, Wilschanski, Michael, and Thapar, Nikhil

Published
2019
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31. Oesophageal atresia

Author

van Lennep, Marinde, Singendonk, Maartje M. J., Dall’Oglio, Luigi, Gottrand, Fréderic, Krishnan, Usha, Terheggen-Lagro, Suzanne W. J., Omari, Taher I., Benninga, Marc A., and van Wijk, Michiel P.

Published
2019
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32. Pediatric ERCP in the Setting of Acute Pancreatitis: A Secondary Analysis of an International Multicenter Cohort Study

Author

Trocchia, Carolena, primary, Khalaf, Racha, additional, Amankwah, Ernest, additional, Ruan, Wenly, additional, Fishman, Douglas S., additional, Barth, Bradley A, additional, Liu, Quin Y., additional, Giefer, Matthew, additional, Kim, Kyung Mo, additional, Martinez, Mercedes, additional, Dall’oglio, Luigi, additional, Torroni, Filippo, additional, De Angelis, Paola, additional, Faraci, Simona, additional, Bitton, Sam, additional, Werlin, Steven, additional, Dua, Kulwinder, additional, Gugig, Roberto, additional, Huang, Clifton, additional, Mamula, Petar, additional, Quiros, J. Antonio, additional, Zheng, Yuhua, additional, Piester, Travis, additional, Grover, Amit, additional, Fox, Victor L., additional, Wilsey, Michael, additional, and Troendle, David M., additional

Published
2023
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40. Technical Outcomes in Pediatric Endoscopic Retrograde Cholangiopancreatography: Data from an International Collaborative

Author

Troendle, David M., primary, Ruan, Wenly, additional, Fishman, Douglas S., additional, Barth, Bradley A., additional, Liu, Quin Y., additional, Giefer, Matthew, additional, Kim, Kyung Mo, additional, Martinez, Mercedes, additional, Dall’oglio, Luigi, additional, Torroni, Filippo, additional, De Angelis, Paola, additional, Faraci, Simona, additional, Bitton, Sam, additional, Wilsey, Michael, additional, Khalaf, Racha, additional, Werlin, Steven, additional, Dua, Kulwinder, additional, Gugig, Roberto, additional, Huang, Clifton, additional, Mamula, Petar, additional, Quiros, J. Antonio, additional, Zheng, Yuhua, additional, Grover, Amit, additional, and Fox, Victor L., additional

Published
2022
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41. Decellularized esophageal tubular scaffold microperforated by quantum molecular resonance technology and seeded with mesenchymal stromal cells for tissue engineering esophageal regeneration

Author

Marzaro, Maurizio, Pozzato, Gianantonio, Tedesco, Stefano, Algeri, Mattia, Pozzato, Alessandro, Tomao, Luigi, Montano, Ilaria, Torroni, Filippo, Balassone, Valerio, Contini, Anna Chiara Iolanda, Guerra, Luciano, D'Angelo, Tommaso, Federici Di Abriola, Giovanni, Lupoi, Lorenzo, Caristo, Maria Emiliana, Boskoski, Ivo, Costamagna, Guido, Francalanci, Paola, Astori, Giuseppe, Bozza, Angela, Bagno, Andrea, Todesco, Martina, Trovalusci, Emanuele, Dall'Oglio, Luigi, Locatelli, Franco, Caldaro, Tamara, Federici di Abriola, Giovanni, Boskoski, Ivo (ORCID:0000-0001-8194-2670), Costamagna, Guido (ORCID:0000-0002-8100-2731), Oglio, Luigi Dall', Locatelli, Franco (ORCID:0000-0002-7976-3654), Marzaro, Maurizio, Pozzato, Gianantonio, Tedesco, Stefano, Algeri, Mattia, Pozzato, Alessandro, Tomao, Luigi, Montano, Ilaria, Torroni, Filippo, Balassone, Valerio, Contini, Anna Chiara Iolanda, Guerra, Luciano, D'Angelo, Tommaso, Federici Di Abriola, Giovanni, Lupoi, Lorenzo, Caristo, Maria Emiliana, Boskoski, Ivo, Costamagna, Guido, Francalanci, Paola, Astori, Giuseppe, Bozza, Angela, Bagno, Andrea, Todesco, Martina, Trovalusci, Emanuele, Dall'Oglio, Luigi, Locatelli, Franco, Caldaro, Tamara, Federici di Abriola, Giovanni, Boskoski, Ivo (ORCID:0000-0001-8194-2670), Costamagna, Guido (ORCID:0000-0002-8100-2731), Oglio, Luigi Dall', and Locatelli, Franco (ORCID:0000-0002-7976-3654)

Abstract

Current surgical options for patients requiring esophageal replacement suffer from several limitations and do not assure a satisfactory quality of life. Tissue engineering techniques for the creation of customized "self-developing" esophageal substitutes, which are obtained by seeding autologous cells on artificial or natural scaffolds, allow simplifying surgical procedures and achieving good clinical outcomes. In this context, an appealing approach is based on the exploitation of decellularized tissues as biological matrices to be colonized by the appropriate cell types to regenerate the desired organs. With specific regard to the esophagus, the presence of a thick connective texture in the decellularized scaffold hampers an adequate penetration and spatial distribution of cells. In the present work, the Quantum Molecular Resonance (R) (QMR) technology was used to create a regular microchannel structure inside the connective tissue of full-thickness decellularized tubular porcine esophagi to facilitate a diffuse and uniform spreading of seeded mesenchymal stromal cells within the scaffold. Esophageal samples were thoroughly characterized before and after decellularization and microperforation in terms of residual DNA content, matrix composition, structure and biomechanical features. The scaffold was seeded with mesenchymal stromal cells under dynamic conditions, to assess the ability to be repopulated before its implantation in a large animal model. At the end of the procedure, they resemble the original esophagus, preserving the characteristic multilayer composition and maintaining biomechanical properties adequate for surgery. After the sacrifice we had histological and immunohistochemical evidence of the full-thickness regeneration of the esophageal wall, resembling the native organ. These results suggest the QMR microperforated decellularized esophageal scaffold as a promising device for esophagus regeneration in patients needing esophageal substitution.

Published
2022

42. Paediatric Gastrointestinal Endoscopy: European Society for Paediatric Gastroenterology Hepatology and Nutrition and European Society of Gastrointestinal Endoscopy Guidelines

Author

Thomson, Mike, Tringali, Andrea, Dumonceau, Jean-Marc, Tavares, Marta, Tabbers, Merit M., Furlano, Raoul, Spaander, Manon, Hassan, Cesare, Tzvinikos, Christos, Ijsselstijn, Hanneke, Viala, Jérôme, Dall’Oglio, Luigi, Benninga, Marc, Orel, Rok, Vandenplas, Yvan, Keil, Radan, Romano, Claudio, Brownstone, Eva, Hlava, Štěpán, Gerner, Patrick, Dolak, Werner, Landi, Rosario, Huber, Wolf D., Everett, Simon, Vecsei, Andreas, Aabakken, Lars, Amil-Dias, Jorge, and Zambelli, Alessandro

Published
2017
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45. SARS-COV2 and Eosinophilic Esophagitis: a first case.

Author

Mennini, Maurizio, primary, Rea, Francesca, additional, Malamisura, Monica, additional, Riccardi, Carla, additional, Dall'Oglio, Luigi, additional, Angelis, Paola De, additional, Fiocchi, Alessandro, additional, and Tambucci, Renato, additional

Published
2022
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47. Predictors of Prolonged Fluoroscopy Exposure in Pediatric Endoscopic Retrograde Cholangiopancreatography: Results From the Large Pediatric Endoscopic Retrograde Cholangiopancreatography Database Initiative Multicenter Cohort

Author

Liu, Quin Y., primary, Ruan, Wenly, additional, Fishman, Douglas S., additional, Barth, Bradley A., additional, Tsai, Cynthia Man-Wai, additional, Giefer, Matthew J., additional, Kim, Kyung Mo, additional, Martinez, Mercedes, additional, Dall’Oglio, Luigi, additional, De Angelis, Paola, additional, Torroni, Filippo, additional, Faraci, Simona, additional, Bitton, Sam, additional, Wilsey, Michael, additional, Khalaf, Racha T., additional, Werlin, Steven, additional, Dua, Kulwinder, additional, Huang, Clifton, additional, Gugig, Roberto, additional, Mamula, Petar, additional, Fox, Victor L., additional, Grover, Amit S., additional, Quiros, J. Antonio, additional, Zheng, Yuhua, additional, and Troendle, David M., additional

Published
2021
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49. Management of Gastrointestinal and Nutritional Problems in Children With Neurological Impairment: A Survey of Practice

Author

Romano, Claudio, Dipasquale, Valeria, Van Winckel, Myriam, Hulst, Jessie, Broekaert, Ilse, Bronsky, Jiri, Dall'Oglio, Luigi, Mis, Natasa Fidler, Hojsak, Iva, Orel, Rok, Papadopoulou, Alexandra, Schaeppi, Michela, Thapar, Nikhil, Wilschanski, Michael, Sullivan, Peter, Gottrand, Frederic, Romano, Claudio, Dipasquale, Valeria, Van Winckel, Myriam, Hulst, Jessie, Broekaert, Ilse, Bronsky, Jiri, Dall'Oglio, Luigi, Mis, Natasa Fidler, Hojsak, Iva, Orel, Rok, Papadopoulou, Alexandra, Schaeppi, Michela, Thapar, Nikhil, Wilschanski, Michael, Sullivan, Peter, and Gottrand, Frederic

Abstract

Objectives: The main aim of this study was to determine the impact on clinical practice of the first European Society of Gastroenterology, Hepatology, and Nutrition (ESPGHAN) position paper on the diagnosis and management of nutritional and gastrointestinal problems in children with neurological impairment (NI). Methods: In this pilot-study, a web-based questionnaire was distributed between November, 2019 and June, 2020, amongst ESPGHAN members using the ESPGHAN newsletter. Fifteen questions covered the most relevant aspects on nutritional management and gastrointestinal issues of children with NI. A descriptive analysis of responses was performed. Results: A total of 150 health professionals from 23 countries responded to the survey. A considerable variation in clinical practice concerning many aspects of nutritional and gastrointestinal management of children with NI was observed. The most frequently used method for diagnosing oropharyngeal dysfunction was the direct observation of meals with or without the use of standardised scores (n = 103). Anthropometric measurements were the most commonly used tools for assessing nutritional status (n = 111). The best treatment for gastroesophageal reflux disease (GERD) was considered to be proton pump inhibitor therapy by most (n = 116) participants. Regarding tube feeding, nearly all respondents (n = 114) agreed that gastrostomy is the best enteral access to be used for long-term enteral feeding. Fundoplication was indicated at the time of gastrostomy placement especially in case of uncontrolled GERD. Conclusions: More studies are required to address open questions on adequate management of children with NI. Identifying knowledge gaps paves the way for developing updated recommendations and improving patient care.

Published
2021

50. An international survey on anastomotic stricture management after esophageal atresia repair:considerations and advisory statements

Author

ten Kate, Chantal A., Tambucci, Renato, Vlot, John, Spaander, Manon C.W., Gottrand, Frederic, Wijnen, Rene M.H., Dall’Oglio, Luigi, ten Kate, Chantal A., Tambucci, Renato, Vlot, John, Spaander, Manon C.W., Gottrand, Frederic, Wijnen, Rene M.H., and Dall’Oglio, Luigi

Abstract

Background: Endoscopic dilatation is the first-line treatment of stricture formation after esophageal atresia (EA) repair. However, there is no consensus on how to perform these dilatation procedures which may lead to a large variation between centers, countries and doctor’s experience. This is the first cross-sectional study to provide an overview on differences in endoscopic dilatation treatment of pediatric anastomotic strictures worldwide. Methods: An online questionnaire was sent to members of five pediatric medical networks, experienced in treating anastomotic strictures in children with EA. The main outcome was the difference in endoscopic dilatation procedures in various centers worldwide, including technical details, dilatation approach (routine or only in symptomatic patients), and adjuvant treatment options. Descriptive statistics were performed with SPSS. Results: Responses from 115 centers from 32 countries worldwide were analyzed. The preferred approach was balloon dilatation (68%) with a guidewire (66%), performed by a pediatric gastroenterologist (n = 103) or pediatric surgeon (n = 48) in symptomatic patients (68%). In most centers, hydrostatic pressure was used for balloon dilatation. The insufflation duration was standardized in 59 centers with a median duration of 60 (range 5–300) seconds. The preferred first-line adjunctive treatments in case of recurrent strictures were intralesional steroids and topical mitomycin C, in respectively 47% and 31% of the centers. Conclusions: We found a large variation in stricture management in children with EA, which confirms the current lack of consensus. International networks for rare diseases are required for harmonizing and comparing the procedures, for which we give several suggestions.

Published
2021

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