Book review – Textbook of oesophageal atresia听
by听Augusto Zani听
Professor of Surgery,听Washington University School of Medicine听
Saint Louis Children鈥檚 Hospital,听Saint Louis,听USA听
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The publication of听Textbook of Oesophageal Atresia听marks an important milestone for the paediatric surgical community. The management of oesophageal atresia and听tracheo-oesophageal fistula (OA/TOF) lies at the heart of paediatric surgery, and centres worldwide regard their outcomes in this condition as a benchmark of excellence.听
The first aspect that strikes the reader is the truly global reach of this academic endeavour. Although the editor,听Devesh Misra听from the听Royal London Hospital, UK, has led the project, the contributing authors听represent听many of the world’s leading centres and include some of the most respected names in the field. Their diverse perspectives provide readers with valuable insights into institutional protocols and clinical philosophies developed across Europe, North America,听Asia听and Australia. The editor has succeeded in creating a volume that is not merely a collection of chapters, but a coherent,听authoritative听and comprehensive reference text.听
The book听comprises听32 chapters covering the entire spectrum of oesophageal atresia. It begins with an engaging historical account by听Georgina Bough听and听Shaun Kunisaki听from听Johns Hopkins University, Baltimore, tracing the remarkable evolution of OA/TOF from its earliest descriptions to the sophisticated surgical techniques of today. This historical perspective is followed by outstanding chapters on embryology and anatomy by听Merrill McHoney听from听Oxford, prenatal diagnosis by听Elena Greco听(Royal London)听and听Francesco Iaculli听from听Bambino Ges霉 Children’s Hospital, Rome, genetics and associated syndromes by听Ami Pedersen听and听Devesh Misra, neonatal management by听V.听Murthy听and congenital cardiac anomalies by听Filip Kucera听and听Oliver Bates听from听Great Ormond Street. Together, these chapters provide an excellent scientific and clinical foundation before the reader embarks on the surgical management of these complex patients.听
Merrill McHoney’s chapter is notable for two reasons. First, it incorporates cross-sectional radiological anatomy, helping surgeons develop a more sophisticated understanding of mediastinal structures. Second, it correlates thoracoscopic findings with听bronchoscopic听and radiological images across the various OA/TOF subtypes, creating a uniquely practical learning resource.听
The medical aspects of care are particularly well represented.听The chapter on听Oesophageal Physiology and Investigative Modalities,听by听Osvaldo Borrelli听from听Great Ormond Street听is particularly impressive.听Containing听over 220 references, it provides an outstanding review of high-resolution impedance manometry (HRIM), endoluminal functional lumen imaging probe (EndoFLIP), and pH-multichannel intraluminal impedance (pH-MII), highlighting the increasingly sophisticated tools now available for evaluating oesophageal function.听
Operative management is explored in exceptional depth. Repair by open thoracotomy receives detailed attention, with Devesh Misra describing听his own听technical refinements developed over more than three decades of experience, resulting in听exceptionally听low complication rates. As听Steve Rothenberg听from听Rocky Mountain Hospital for Children, Denver,听observes听in his foreword, the logical next step听should听be the incorporation of these principles into thoracoscopic and robotic platforms.听
As minimally invasive surgery continues to gain wider acceptance, it is fitting that four chapters are devoted to this approach.听Dariusz Patkowski听from听Wroclaw Medical University, Poland, one of the pioneers of thoracoscopic repair of OA, authors the principal chapter and presents updated results extending to 2025. Complementary chapters听by听Ravi Kanojia听from听PGIMER,听India,听discuss anaesthesia for thoracoscopy, intraoperative complications, and the important but often under-discussed topic of conversion to open surgery.听Nor Lan Lau听and听Anil Visram听also provide an excellent overview of anaesthesia for open repair, reminding readers that听optimal听outcomes depend as much on advances in perioperative care as on surgical technique itself.听
No textbook on oesophageal atresia would be complete without a comprehensive discussion of long-gap OA. This challenging condition is addressed in five outstanding chapters.听Agostino Pierro听from听Hospital for Sick Children, Toronto, together with听Lorenzo A帽ez Bustillos, provides an authoritative overview of delayed primary repair and gastric transposition, while听Thomas Hamilton听from the听Children’s Hospital of Philadelphia听discusses the Foker鈥檚 technique with its minimally invasive evolution,听and听Benjamin Zendejas听from听Boston Children鈥檚 hospital听discusses the super-charged jejunal interposition technique. Colonic interposition听has been听modified听by听M.听Eldebeiky听and team from听Cairo听and听is听presented with vivid photographs.听These chapters reflect both the remarkable ingenuity that has characterised this field and the continuing commitment to preserving the native oesophagus whenever possible.听
The Melbourne group published the first textbook dedicated to oesophageal atresia more than 35 years ago.听It is fitting that听Warwick Teague听and听Ram Nataraja听from the听Royal Children’s Hospital,听Melbourne, continue that tradition with an excellent chapter on H-type听tracheo-oesophageal fistula. Equally impressive is the contribution from听Great Ormond Street Hospital, where听Ben Hartley,听Paolo De Coppi,听Stefano Giuliani,听Dhanya听Mullassery, and colleagues share their extensive experience in bronchoscopy, tracheomalacia, strictures, missed upper pouch fistula听and recurrent听tracheo-oesophageal fistula.听Oliver Muensterer听from听Munich听discusses the ubiquitous problem of anastomotic leaks.听Additional听chapters address important but less听common challenges, including right-sided aortic arch and chylothorax, ensuring that readers are well equipped to manage the full spectrum of perioperative and postoperative complications.听
The controversies surrounding gastro-oesophageal reflux are thoughtfully discussed by听Osvaldo Borrelli听from听Great Ormond Street听Hospital,听听while听the surgical management of reflux is reviewed by听Riadh Cheddadi听and听Augusto Zani from Washington University,听St. Louis. Together, these chapters provide a balanced overview of one of the most debated aspects of long-term OA management.听
Recognising that听the vast majority of听children with OA now survive well into adulthood, the textbook includes dedicated chapters on long-term respiratory morbidity and gastrointestinal follow-up.听Caroline Pao听and听Rebecca Thursfield听from听Alder Hey Children鈥檚 hospital,听Liverpool听discuss respiratory outcomes, while听Shawn St. Peter听from听Children’s Mercy Kansas City, Missouri, provides a particularly valuable review of endoscopic surveillance and the potential risk of oesophageal malignancy in adult survivors, emphasising the importance of lifelong multidisciplinary care.听
One of the most enjoyable chapters is听Radiological Case Studies, Atypical Cases and Lessons Learned Over 35 Years in Oesophageal Atresia, written by听Devesh Misra听together with radiologist听Anoushka Ljutikov. The carefully selected cases challenge even experienced surgeons and illustrate the wealth of practical knowledge accumulated over an exceptional career devoted to this condition. Throughout the book, readers will听encounter听similar clinical pearls, technical insights and thoughtful observations听from Misra听that transform a reference textbook into听a听distillation of decades of experience.听
The educational value of the textbook extends beyond its clinical content. Devesh Misra shares听mentoring听advice on听how to听publish long clinical series and lifetime work, followed by a self-assessment quiz听by听M Abdullah听and听Shilpa Sharma听from听AIIMS, New Delhi听that will be particularly valuable for trainees preparing for examinations. The book concludes with an excellent overview of the landmark international TOAST trial by听Iain Yardley听from听Evelina听Children’s Hospital, and听Nigel Hall听from the听University of Southampton,听highlighting how collaborative multicentre research continues to shape the future of OA care.听
Springer has produced this volume to听a very high听standard. The high-quality colour illustrations, operative photographs, radiological images,听bronchoscopic听images, and diagrams听greatly enhance听the educational value of the text.听
Few textbooks succeed in bringing together the collective wisdom of so many pioneers in a single volume. Through Devesh Misra’s vision and the contributions of experts from many of the world’s leading centres,听Textbook of Oesophageal Atresia听achieves exactly that. Comprehensive,听authoritative听and beautifully illustrated, it is destined to become the definitive reference on oesophageal atresia and听tracheo-oesophageal fistula, and an indispensable resource for paediatric surgeons, trainees, neonatologists, gastroenterologists,听pulmonologists听and all clinicians involved in the care of these complex patients.听
Augusto Zani听
Professor of Surgery, Washington University School of Medicine听
Saint Louis Children鈥檚 Hospital, Saint Louis, USA听