Review for 10.1186/s12876-022-02207-y (2022)

Reviewer’s report
Title: 
Endoscopic recanalization for the complete closure of long-gap
esophageal atresia after reconstruction surgery
Version: 
1 
Date: 
01 Feb 2022
Reviewer's report:
Many thanks for the changes and revisions implemented.
The clarifications about clinical history, highlight some findings of note:
1. Post-operative esophageal leakage could be defined as "minor" since it was
successfully managed conservatively. Conversely, in case of major anastomotic
leaks prompt surgical treatment is mandatory. Even though minor leaks leave a
certain degree of mediastinal adhesion, no severe adhesion (frozen mediastinum)
should be expected.
2. Ballooning of esophageal stenosis, performed twice under fluoroscopy, was
partially effective (not ineffective!) since the patient was discharged home and
only months after dilation, developed clinically significant stenosis. On this
regard, it was not clear why the Authors decided not to leave a nasogastric tube
after dilation. This simple maneuver would allow maintenance of esophageal
route after dilation, also allowing enteral feeding if needed. After the 2nd
dilation, did the patients discharged home on oral feeding?
3. The esophageal stenosis the authors faced, was not definable as "refractory
stricture" since the relatively low number of dilations performed before the
reported last endoscopic dilation. This is, in my opinion, the main reason why a
third ballooning was effective to treat esophageal stenosis. 
Since esophageal stenosis was not a refractory one, there were no indication for
direct surgery, even if, in case of unsuccessful endoscopic esophageal
recanalization, re-thoracotomy was probably the only way to go.
Based on the above comments, I would suggest to extensively modify case report
to make clinical history clearer, also revising discussion. I would also add a
paragraph on detailed follow-up program the patient followed: did he perform
routine endoscopic evaluation after esophageal recanalization? How many
dilations were required to stabilize post-recanalization esophageal stenosis?
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