An innovative technique used for the first time in Italy to treat oesophageal atresia in infants is called magneto-anastomosis

This is the innovative technique used for the first time in Italy by doctors at the Bambino Gesù Children’s Hospital to treat oesophageal atresia, a rare congenital malformation that results in a missing part of the oesophagus and prevents babies from eating normally through the mouth.

Thanks to the action of two magnets, positioned at the ends of the oesophageal stumps, it is possible to re-establish the continuity of the oesophagus without surgery.

CHILD HEALTH: LEARN MORE ABOUT MEDICHILD BY VISITING THE BOOTH AT EMERGENCY EXPO

The first 5 children treated by the hospital, all under 4 months of age, have been described in the scientific journal Journal of Paediatric Surgery.

Only 25 cases have been described to date in the literature at an international level.

OESOPHAGEAL ATRESIA

Oesophageal atresia is a malformation characterised by an interruption of the oesophagus, the part of the digestive tract that allows food to pass from the mouth to the stomach.

It is a rare congenital anomaly with unknown causes, whose frequency ranges from a maximum of 1 in 2500 to a minimum of 1 in 4000 live births.

In many cases, atresia of the oesophagus is associated with the presence of an abnormal communication (tracheoesophageal fistula) with the trachea.

In a minority of cases, approximately 10-15% of the total, abnormal communication with the trachea is not present, but the distance between the two stumps of the oesophagus is greater.

In this case, one speaks of long-gap oesophageal atresia

Both variants of oesophageal atresia are usually treated in the first few months of life with very effective surgery, but they also have the known risks inherent in the specific technique as well as the general risks of surgery on the chest of an infant or an infant weighing only a few kilos.

THE NEW TECHNIQUE

Magneto-anastomosis is an innovative and non-invasive technique that makes it possible to treat, without resorting to actual surgery, atresia of the oesophagus in its less common variant, that without a tracheo-oesophageal fistula, also known as ‘long-gap’.

It is performed by placing magnets, two 0.5-cm-diameter magnets, at the end of the two non-communicating stumps of the oesophagus.

One is placed in the upper stump, using a soft tube and passing through the mouth, the other is placed in the lower stump by passing a similar tube through a small feeding opening at stomach level. Children with long-gap oesophageal atresia have to be temporarily fed artificially until the problem is resolved.

Once the magnets are in place, the two stumps of the oesophagus are pushed towards each other, controlling the movement under radioscopic guidance, until the two magnets come close enough for them to attract and come together thanks to the force generated by the magnetic field.

The procedure takes about an hour on average compared to the 2 to 4 hours of the classic surgical technique.

Within about a week, the pressure exerted by the magnets ‘erodes’ the walls of the oesophagus, opening the passage between the upper and lower stump.

At the same time, thanks to the prolonged contact, the two stumps are welded together.

Thus, the oesophagus is now ‘continuous’ and ‘pervious’, i.e. open and no longer ‘atresic’.

At the end of this process, the two magnets are removed by simply pulling out the soft tube on which they were placed.

The child is then immediately re-fed by mouth and undergoes a few sessions of dilation of the oesophagus (as happens when the classic surgical technique is used) to allow it to have an adequate width even for the passage of food more consistent than milk.

OESOPHAGEAL ATRESIA, INFANTS TREATED AT THE BAMBINO GESU

The cases of the first 5 patients treated in Italy at the Bambino Gesù with the innovative minimally invasive technique, all infants under 4 months old, have been described in the scientific journal Journal of Paediatric Surgery.

All 5 babies are doing well and have returned home after the interventional procedure with magnets.

So far, a total of 8 children have been treated at the Holy See Hospital, all under 6 months old: 3 were from Lazio, 2 from Apulia, 1 from Calabria, 1 from Sicily and 1 from Lombardy.

‘The advantages of this new technique are many,’ explains Professor Pietro Bagolan, director of the medical-surgical Department of the foetus-neonate-lactant.

In addition to avoiding the stress and possible consequences (postoperative pain, surgical wound, even if minimal, etc.) of a classic or minimally invasive thoracoscopic surgery, children also have a much easier and often much quicker course before they can finally eat naturally by mouth.

In addition, there is no scarring, not even internal, associated with classic surgical access.

This makes any future operations easier and more agile due to the absolute respect for the anatomy of the thorax and mediastinum, the delicate anatomical region where the oesophagus is housed’.

LIMITATIONS AND FUTURE PROSPECTS

In the international scientific literature, only 25 cases of magneto-anastomosis have been described to date.

Too few yet to understand whether certain postoperative risks – such as stenosis, i.e. the danger of narrowing of the oesophagus – are greater or lesser than with the traditional surgical technique, and possibly why.

For this reason, an international multicentre study will soon begin, to develop and test new magnets specially patented for clinical use, which should be able to reduce this risk.

The study will last about 2 years and will involve 6 centres worldwide including, for Italy, the Bambino Gesù.

Read Also:

Emergency Live Even More…Live: Download The New Free App Of Your Newspaper For IOS And Android

Rare Diseases: Bardet Biedl Syndrome

Rare Diseases: Positive Results Of A Phase 3 Study For The Treatment Of Idiopathic Hypersomnia

Rare Diseases: Fibrodysplasia Ossificans Progressiva (FOP), A Study From Pennsylvania University

Rare Diseases, Neonatal Screening: What It Is, Which Diseases It Covers And What Happens If It Is Positive

Prune-Belly Syndrome: Causes, Symptoms, Diagnosis, Treatment, Prognosis

Fetal Surgery, Surgery On Laryngeal Atresia At Gaslini: The Second In The World

Source:

Bambino Gesù