Very long gap esophageal atresia successfully treated by esophageal lengthening using external traction sutures.

Esophageal atresia with a 6-cm gap or longer and a very short distal segment represents the extreme of this disorder's spectrum, the treatment of which can be challenging. Very often, several surgical procedures have to be carried out to maintain the patient's own esophagus. The authors report on a child born with isolated esophageal atresia without fistula and a very long gap (8.5 vertebral spaces in length). Delayed anastomosis was accomplished using a combination of various procedures that included a waiting period allowing for spontaneous esophageal growth, mobilization of the distal segment, and esophageal lengthening by external traction sutures. The aim of this report is to define the role of the traction method in the repair of this kind of atresia.