# Type C Esophageal Atresia — GCMD Library living collection Everything in the library about type C esophageal atresia — built automatically from dossiers that name it. Updated: n/a · 3 episodes · 54 cited statements ## Episodes ### Surgical Management - [Esophageal Atresia - Arnold Coran: Update Course 2014](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653) — video · [machine version](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653.md) ### Evidence & Research - [Journal of Pediatric Surgery Article Review: 1st Quarter (Jan-Mar) 2025](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484) — podcast · 16:35 · [machine version](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484.md) - [Journal of Pediatric Surgery Article Review: 2nd Quarter (Apr-Jun) 2025](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786) — podcast · 16:35 · [machine version](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786.md) ## Chapters - [0:00](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=0) Introduction and Technical Discussion of Vascular Access (Ep 1) - [3:51](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=231) Historical Context and Proximal Fistula Incidence (Ep 1) - [6:58](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=418) Diagnostic Evaluation for Proximal Fistulas (Ep 1) - [12:31](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=751) Long-Gap Esophageal Atresia Initial Assessment (Ep 1) - [18:39](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=1119) Decision-Making for Primary Repair vs. Replacement (Ep 1) - [22:40](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=1360) Esophageal Replacement Strategies (Ep 1) - [0:04](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=4) Tracheobronchopexy for severe airway collapse after esophageal atresia repair (Ep 2) - [4:11](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=251) Pediatric surgical outreach mapping in Canada (Ep 2) - [10:22](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=622) Quality improvement targets in gastrostomy tube placement (Ep 2) - [0:04](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=4) Tracheobronchopexy for severe airway collapse after esophageal atresia repair (Ep 3) - [4:11](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=251) Pediatric surgical outreach mapping across Canada (Ep 3) - [10:22](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=622) Quality improvement targets in pediatric gastrostomy tube placement (Ep 3) ## Statements Every statement is attributed, typed, and timestamped; the link is the citation. - "A subset of children after esophageal atresia repair experience severe airway collapse, leaving them ventilator dependent or suffering repeated cyanotic spells" — Em Gootee (host_summary) [Ep 2 · 1:41](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=101) - "80 patients with severe airway collapse after esophageal atresia is a huge number; most pediatric surgeons won't see 10 such patients in their career, and many wouldn't see 5" — George W. Holcomb III (epidemiological) [Ep 2 · 2:17](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=137) - "90% of patients showed complete airway collapse on dynamic bronchoscopy" — George W. Holcomb III (host_summary) [Ep 2 · 2:34](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=154) - "Three-quarters of tracheobronchopexy procedures used a posterior approach" — George W. Holcomb III (host_summary) [Ep 2 · 2:40](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=160) - "Tracheobronchopexy was performed on thoracic trachea alone in over half the patients, but had to be extended onto the bronchi in 40%" — George W. Holcomb III (host_summary) [Ep 2 · 2:44](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=164) - "94% of patients avoided tracheostomy with a mortality rate of 5%, and the procedure significantly reduced pressure ventilation and ventilator dependence" — George W. Holcomb III (host_summary) [Ep 2 · 2:57](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=177) - "In experienced hands who have done numerous or hundreds of these procedures, tracheobronchopexy can have very good outcomes for patients with severe airway collapse symptoms" — George W. Holcomb III (opinion) [Ep 2 · 3:14](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=194) - "Canada is the second largest country in the world geographically, though population-wise smaller than California" — Eric Skarsgard (epidemiological) [Ep 2 · 5:28](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=328) - "The majority of Canada's population lives within 200 kilometers of the US border, but there are definitely lots of children in remote communities where it is not easy to access care" — Eric Skarsgard (epidemiological) [Ep 2 · 5:38](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=338) - "Outreach services were present in only 7 out of 10 provinces, and only 8 out of 18 children's hospitals (44%) provided outreach services" — Preet Bir (epidemiological) [Ep 2 · 6:43](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=403) - "A significant number of outreach services are located within 50 kilometers of a children's hospital, leaving vast regions without access to pediatric surgical care" — Em Gootee (host_summary) [Ep 2 · 6:57](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=417) - "In most places in Canada, no one would transfer a 16 or 17 year old with appendicitis to a children's hospital for surgery; physiologically and every other way they're an adult and do not need the expertise of a pediatric surgeon" — Eric Skarsgard (clinical) [Ep 2 · 7:36](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=456) - "It's a misconception that the Canadian healthcare system ensures timely care; it actually doesn't, and children wait for surgery beyond their wait time target" — Eric Skarsgard (clinical) [Ep 2 · 8:01](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=481) - "Newfoundland and Labrador has the best outreach setup with only two pediatric surgeons who have established outreach clinics all over the province, serving as a model to others" — Eric Skarsgard (clinical) [Ep 2 · 8:16](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=496) - "The population of Newfoundland and Labrador is really rural and spread out, and weather-wise it can be impossible sometimes to access care or financially devastating" — Eric Skarsgard (epidemiological) [Ep 2 · 8:31](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=511) - "There are measurable costs of living remote to accessible high-quality care in terms of time required to be seen and actual clinical outcomes" — Eric Skarsgard (clinical) [Ep 2 · 9:01](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=541) - "In the NSQIP database, 5% of all pediatric procedures were G-tube, which is a pretty sizable percent" — Sean Kunisaki (epidemiological) [Ep 2 · 11:56](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=716) - "The study examined 4,612 G-tube placements from 71 NSQIP-Pediatric hospitals in 2023" — Em Gootee (host_summary) [Ep 2 · 12:38](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=758) - "77% of G-tube cases were first-time G-tubes as opposed to redos" (epidemiological) [Ep 2 · 12:46](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=766) - "Upper GI studies were obtained in 45% of first-time G-tube cases with substantial interhospital variability from 0 to 99%" — Em Gootee (host_summary) [Ep 2 · 13:04](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=784) - "The heterogeneity in use of preoperative upper GIs was extremely broad with no real reason, indicating a potential teaching moment" — Sean Kunisaki (opinion) [Ep 2 · 13:20](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=800) - "14% of G-tube cases resulted in an ED visit within 0 to 30 days" — Em Gootee (host_summary) [Ep 2 · 13:45](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=825) - "5.2% of G-tube cases involved dislodgement within 0 to 30 days" — Em Gootee (host_summary) [Ep 2 · 13:45](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=825) - "An additional 5.5% of G-tubes were dislodged in the 31 to 60 day period" (clinical) [Ep 2 · 13:55](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=835) - "Dislodgement rates are higher than rates of readmissions or IR interventions, making dislodgements a great QI target" (opinion) [Ep 2 · 13:55](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=835) - "If you can get dislodgements down, ED visits go down; when dislodgements happen early, patients are told to come back to the ED" (clinical) [Ep 2 · 14:15](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=855) - "A subset of children after esophageal atresia repair experience severe airway collapse, leaving them ventilator dependent or suffering repeated cyanotic spells" — Em Gootee (host_summary) [Ep 3 · 1:48](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=108) - "The tracheobronchopexy series included 80 patients, which is a huge number - most pediatric surgeons won't see 10 of these patients in their career, and many wouldn't see 5" — George W. Holcomb III (epidemiological) [Ep 3 · 2:17](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=137) - "90% of patients on dynamic bronchoscopy showed complete airway collapse" — George W. Holcomb III (host_summary) [Ep 3 · 2:34](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=154) - "Three-quarters of tracheobronchopexy procedures used a posterior approach" — George W. Holcomb III (host_summary) [Ep 3 · 2:40](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=160) - "Tracheobronchopexy was performed on thoracic trachea alone in over half the patients, but had to be extended onto the bronchi in 40%" — George W. Holcomb III (host_summary) [Ep 3 · 2:44](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=164) - "94% of tracheobronchopexy patients avoided tracheostomy with a mortality rate of 5%" — George W. Holcomb III (host_summary) [Ep 3 · 2:57](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=177) - "Tracheobronchopexy significantly reduced pressure ventilation and ventilator dependence" — George W. Holcomb III (host_summary) [Ep 3 · 2:57](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=177) - "In experienced hands who have done numerous or hundreds of these type procedures, tracheobronchopexy can have very good outcomes for patients with severe airway collapse symptoms" — George W. Holcomb III (opinion) [Ep 3 · 3:14](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=194) - "Canada is the 2nd largest country in the world geographically, though population-wise smaller than California" — Eric Skarsgard (epidemiological) [Ep 3 · 5:28](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=328) - "The majority of Canada's population lives within 200 kilometers of the US border, but there are definitely lots of children in remote communities where it is not easy to access care" — Eric Skarsgard (epidemiological) [Ep 3 · 5:38](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=338) - "Outreach services were present in only 7 out of 10 provinces, and only 8 out of 18 children's hospitals (44%) provided outreach services" — Preet Bir (epidemiological) [Ep 3 · 6:43](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=403) - "A significant number of outreach services are located within 50 kilometers of a children's hospital, leaving vast regions without access to pediatric surgical care" — Em Gootee (host_summary) [Ep 3 · 6:57](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=417) - "In most places in Canada, no one would ever transfer a 16 or 17 year old with appendicitis to a children's hospital for surgery - physiologically and every other way they're an adult and clearly do not need the expertise of a pediatric surgeon" — Eric Skarsgard (opinion) [Ep 3 · 7:36](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=456) - "Access to surgical care for children in Canada has been in need of improvement for decades" — Eric Skarsgard (opinion) [Ep 3 · 7:51](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=471) - "It's a misconception that the Canadian healthcare system ensures timely care - it actually doesn't, and children wait for surgery beyond their wait time target" — Eric Skarsgard (clinical) [Ep 3 · 8:01](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=481) - "Newfoundland and Labrador has the best outreach setup with only two pediatric surgeons who have established outreach clinics all over the province, serving as a model for others" — Eric Skarsgard (opinion) [Ep 3 · 8:16](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=496) - "The population of Newfoundland and Labrador is really rural and spread out, and geographically and weather-wise it can be impossible sometimes to access care or financially devastating" — Eric Skarsgard (epidemiological) [Ep 3 · 8:31](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=511) - "There are measurable costs in terms of time required to be seen and actual clinical outcomes for patients living remote from accessible high quality care" — Eric Skarsgard (clinical) [Ep 3 · 9:01](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=541) - "In the NSQIP database, 5% of all pediatric procedures were G-tube, which is a pretty sizable percent" — Sean Kunisaki (epidemiological) [Ep 3 · 11:56](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=716) - "The study examined 4,612 G-tube placements from 71 NSQIP-Pediatric hospitals in 2023" — Em Gootee (host_summary) [Ep 3 · 12:38](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=758) - "77% of G-tube cases were first-time G-tubes as opposed to redos" (epidemiological) [Ep 3 · 12:46](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=766) - "Upper GI studies were obtained in 45% of first-time G-tube cases with substantial interhospital variability from 0 to 99%" — Em Gootee (host_summary) [Ep 3 · 13:04](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=784) - "The heterogeneity in use of preoperative upper GIs was extremely broad with no real reason for it, indicating a potential teaching moment" — Sean Kunisaki (opinion) [Ep 3 · 13:23](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=803) - "14% of G-tube cases resulted in an ED visit within 0 to 30 days" — Em Gootee (host_summary) [Ep 3 · 13:45](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=825) - "5.2% of G-tube cases involved dislodgement within 0 to 30 days" — Em Gootee (host_summary) [Ep 3 · 13:45](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=825) - "An additional 5.5% of G-tubes were dislodged in the 31 to 60 day period" (epidemiological) [Ep 3 · 13:55](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=835) - "Dislodgement rates are higher than rates of readmissions or IR interventions, making them a great QI target" (opinion) [Ep 3 · 13:55](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=835) - "If you can get dislodgements down, ED visits go down - when dislodgements happen early, patients are told to come back to the ED" (clinical) [Ep 3 · 14:15](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=855) - "Cameron Haight performed the first esophageal atresia repair in 1941 and managed over 300 cases during his career." — Arnold Coran (clinical) [Ep 1 · 3:51](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=231) - "The incidence of proximal fistula in type C esophageal atresia (with distal fistula) is approximately 10% based on a Netherlands study, significantly higher than the previously reported 1%." — Arnold Coran (epidemiological) [Ep 1 · 5:39](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=339) - "The incidence of proximal fistula in pure esophageal atresia is much higher than in type C esophageal atresia." (clinical) [Ep 1 · 7:26](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=446) - "Bronchoscopy should be performed in all cases to evaluate for proximal fistula." (host_summary) [Ep 1 · 6:05](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=365) - "Contrast pouchography using approximately 1.5 cc of water-soluble contrast carries low aspiration risk and can identify proximal fistulas or suggest their presence when the upper pouch appears narrower than expected." — Arnold Coran (clinical) [Ep 1 · 10:33](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=633) - "A pouchogram can help determine the side of the aortic arch when timely cardiology evaluation is not available." — Arnold Coran (clinical) [Ep 1 · 8:40](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=520) - "Air insufflation into the proximal pouch on plain radiograph can help identify proximal fistulas; absence of a dilated proximal pouch raises concern for a proximal fistula." (clinical) [Ep 1 · 12:02](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=722) - "Gastrostomy tube placement should be performed in the first 24 hours for pure esophageal atresia cases." (guideline) [Ep 1 · 13:52](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=832) - "Blind advancement of Bakes dilators from the gastrostomy site can push the gastric fundus up into the left chest, falsely suggesting a shorter gap than actually exists." (clinical) [Ep 1 · 14:53](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=893) - "Neonatal gastroscope visualization of the distal esophageal segment under fluoroscopy is the best way to assess gap distance." (opinion) [Ep 1 · 16:09](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=969) - "Contrast studies do not show the full extent of the lower esophageal segment." (clinical) [Ep 1 · 17:05](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=1025) - "Initial gap assessment should be delayed at least three weeks after gastrostomy placement to allow the gastrostomy site to mature and avoid displacing the stomach during endoscopy." — Arnold Coran (guideline) [Ep 1 · 17:56](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=1076) - "A gap of two vertebral bodies is the classic teaching for what can likely be brought together for primary repair." (host_summary) [Ep 1 · 19:33](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=1173) - "A gap of three vertebral bodies or less is reasonable to attempt primary repair, with the likelihood of success depending partly on the size of the upper pouch." (opinion) [Ep 1 · 18:39](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=1119) - "There is no need to rush primary repair in the early neonatal period at three weeks; waiting 12 weeks is reasonable as babies grow well with gastrostomy feedings." — Arnold Coran (opinion) [Ep 1 · 20:03](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=1203) - "The Foker procedure is associated with complications including massive gastroesophageal reflux, aspiration, and potentially poor long-term esophageal motility and function." — Arnold Coran (opinion) [Ep 1 · 20:33](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=1233) - "At approximately three months, the gap should be reassessed and a decision made, as most believe the gap will not grow significantly larger after this time." — Arnold Coran (opinion) [Ep 1 · 24:02](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=1442) - "Sequential gap studies should be performed every three weeks after the initial assessment; if no change is observed, waiting longer is not worthwhile." (guideline) [Ep 1 · 24:29](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=1469) - "Traditional teaching suggests esophageal replacement should not be performed until the child can sit upright or walk (between six and 12 months) to minimize reflux complications." — Arnold Coran (guideline) [Ep 1 · 21:50](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=1310) - "Reverse gastric tube without spit fistula can be performed between three and six months of age for long-gap esophageal atresia." (clinical) [Ep 1 · 25:14](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=1514) - "If esophageal replacement is delayed beyond six months, a spit fistula should probably be created because the child will never eat without it." (opinion) [Ep 1 · 25:14](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=1514) - "Esophageal replacement options include colon interposition, gastric pull-up, jejunal interposition, and reverse gastric tube." — Arnold Coran (clinical) [Ep 1 · 22:40](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=1360) - "The gastroesophageal junction in neonates is remarkably small, making blind instrumentation difficult." (clinical) [Ep 1 · 16:09](https://library.globalcastmd.com/watch/esophageal-atresia-arnold-coran-update-course-2014-653?t=969) ## Changelog - Sep 25: 3 items added automatically --- Educational content from recorded physician discussions — not medical advice. Cite the canonical URL or the ?t= deep link. Policy: https://library.globalcastmd.com/ai