Endoscopic Ultrasound Findings in Esophageal Atresia Following Surgical Repair

Study Overview
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Brief Summary
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Children with esophageal atresia who undergo surgical repair are at risk for anastomotic stricture following surgery. Esophageal stricture can be treated with serial endoscopic dilation but may ultimately need surgical resection if the stricture proves refractory to therapy. Several risk factors have been reported for development of recalcitrant stricture, but to date, no studies have specifically examined the relationship between anastomotic thickness and echotexture at time of initial postoperative endoscopy and treatment outcomes. Other risk factors that have been implicated in the development of recalcitrant stricture include gastroesophageal reflux disease, anastomotic leak, long-gap esophageal atresia, and gestational age. Moreover, it is poorly understood how esophageal layers alter and progress with repeated therapeutic dilation. The investigator hypothesize that the initial thickness and echotexture will help determine therapeutic outcome. It will also help us understand the progression of esophageal echotexture following therapeutic dilation.

Official Title
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Endoscopic Ultrasound Findings in Esophageal Atresia Following Surgical Repair

Conditions
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Esophageal Atresia

Intervention / Treatment
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* Device: Pediatric endoscopic ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - Patients ages 0-21 years old at time of evaluation with a suspected diagnosis of esophageal stricture secondary to esophageal atresia (with or without Tracheoesophageal fistula) post surgical repair Exclusion Criteria: Patients with pre-diagnosis of eosinophilic esophagitis Patients with pre-diagnosis of congenital esophageal stricture Patients diagnosed with esophageal stricture secondary to caustic ingestion Patient is diagnosed with an esophageal perforation at time of endoscopy

Ages Eligible for Study
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Minimum Age: 1 Month
Maximum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Patients with esophageal stricture following surgical repair<br>Patients with esophageal atresia following surgical repair who developed an esophageal stricture | Device: Pediatric endoscopic ultrasound<br>* endoscopic ultrasound at the esophageal stricture site to assess echo texture and esophageal layers<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Predict post surgical primary repair outcome in patients with esophageal atresia using endoscopic ultrasound | Patients with esophageal atresia following surgical repair will undergo an endoscopic ultrasound procedure to measure esophageal layer thickness and to describe esophageal echo-texture characteristics at the anastomotic site | 2 years |