We report a case in which Tumguide® was used to identify the proximal esophageal pouch during the repair of congenital esophageal atresia. A male neonate was diagnosed with congenital esophageal atresia (Gross type A) immediately after birth. A long-gap esophageal atresia was suspected, and gastrostomy was performed on day 1 of age. The esophageal gap was approximately two vertebral bodies. Esophageal elongation using the Howard method was performed for approximately 3 months, followed by definitive repair at 3 months of age. During surgery, to identify the proximal esophageal pouch, a Tumguide® fiber (outer diameter 0.5 mm) was inserted through a 24-Fr Nelaton catheter and advanced orally. Illumination clearly delineates the contour of the proximal esophageal pouch, enabling safe dissection without injury to the esophageal wall. The postoperative course was uneventful, and the patient was discharged at 5 months of age. Tumguide® may be a useful device for safely dissecting the proximal esophageal pouch in the repair of congenital esophageal atresia.
Saito et al. (Sun,) studied this question.