Liu SQ, Li SQ, Sun YM, Li YF. Combined magnetic recanalization and laparoscopic antireflux surgery for complex esophageal comorbidities in an infant with congenital esophageal atresia. World J Gastroenterol 2026; 32(48): 123390 [DOI: 10.3748/wjg.123390]
Corresponding Author of This Article
Yu-Feng Li, Department of Pediatric Surgery, Guilin Maternal and Child Health Hospital, No. 26 Fengbei Road, Guilin 541001, Guangxi Zhuang Autonomous Region, China. lyf791001@sina.com
Research Domain of This Article
Pediatrics
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case-report
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Liu SQ, Li SQ, Sun YM, Li YF. Combined magnetic recanalization and laparoscopic antireflux surgery for complex esophageal comorbidities in an infant with congenital esophageal atresia. World J Gastroenterol 2026; 32(48): 123390 [DOI: 10.3748/wjg.123390]
World J Gastroenterol. Dec 28, 2026; 32(48): 123390 Published online Dec 28, 2026. doi: 10.3748/wjg.123390
Combined magnetic recanalization and laparoscopic antireflux surgery for complex esophageal comorbidities in an infant with congenital esophageal atresia
Shi-Qi Liu, Si-Qi Li, Yin-Min Sun, Yu-Feng Li
Shi-Qi Liu, Medical College, Xijing University, Xi’an 710061, Shaanxi Province, China
Si-Qi Li, Yin-Min Sun, School of Clinical Medicine, Shaanxi University of Chinese Medicine, Xianyang 712000, Shaanxi Province, China
Yu-Feng Li, Department of Pediatric Surgery, Guilin Maternal and Child Health Hospital, Guilin 541001, Guangxi Zhuang Autonomous Region, China
Author contributions: Liu SQ contributed to manuscript writing and editing, data collection, and data analysis; Li SQ and Sun YM guided the surgical procedure and revised the manuscript; Li YF contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
AI contribution statement: The authors take full responsibility and accountability for all content of this manuscript, including any portions for which AI tools were used as assistive technologies. All AI-assisted outputs were carefully reviewed, validated, and approved by the authors. AI tools were not used to generate original scientific data, perform independent scientific analyses, or draw scientific conclusions.
Supported by National Natural Science Foundation of China, No. 82170676; and the Key Project of Shaanxi Province's 14th Five-Year Education Science Planning for 2024: Research on the Training Model for Top-notch Innovative Talents in Higher Education Institutions of Shaanxi Province, No. SGH24Z16.
Informed consent statement: Informed written consent was obtained from the patient’s parents for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Yu-Feng Li, Department of Pediatric Surgery, Guilin Maternal and Child Health Hospital, No. 26 Fengbei Road, Guilin 541001, Guangxi Zhuang Autonomous Region, China. lyf791001@sina.com
Received: May 18, 2026 Revised: July 11, 2026 Accepted: September 4, 2026 Published online: December 28, 2026 Processing time: 170 Days and 20.2 Hours
Abstract
BACKGROUND
Congenital esophageal atresia (CEA) is a critical neonatal anomaly requiring timely surgical intervention. Anastomotic stricture represents the most frequent long-term complication, affecting 30% to 50% of repaired cases. Refractory strictures are particularly challenging when compounded by concurrent gastroesophageal reflux disease (GERD) and hiatal hernia, as these conditions synergistically sustain local inflammation, impair healing, and promote recurrent fibrosis.
CASE SUMMARY
We describe a 7-month-old male infant with Gross type III CEA who developed a refractory anastomotic stricture after primary repair, unresponsive to seven sessions of endoscopic balloon dilation. Preoperative workup identified severe gastroesophageal reflux and a hiatal hernia as key perpetuating factors. The patient underwent a single-stage combined minimally invasive procedure, consisting of endoscopic magnetic compression anastomosis for stricture recanalization, followed by laparoscopic hiatal hernia repair and Nissen fundoplication. The procedure lasted 3.5 hours with negligible blood loss. The magnets were removed endoscopically at 32 days, revealing a well-healed anastomosis with a luminal diameter of approximately 8 mm. Mild restenosis occurred at 20 months postoperatively and was effectively managed with five additional dilations. At 3 years and 7 months of follow-up, the child maintained a normal oral diet, remained symptom-free, and exhibited growth and development appropriate for his age.
CONCLUSION
In this infant, single-stage magnetic recanalization combined with laparoscopic antireflux surgery proved feasible for refractory anastomotic stricture with GERD and hiatal hernia, achieving favorable medium-term patency and symptom control. This approach may interrupt the reflux-stricture cycle while avoiding open revision, though further study in larger series is needed.
Core Tip: We report a 7-month-old infant with congenital esophageal atresia who developed a refractory anastomotic stricture, hiatal hernia, and severe gastroesophageal reflux after primary repair. A single-stage combined procedure, consisting of endoscopic magnetic compression anastomosis followed by laparoscopic hiatal hernia repair and Nissen fundoplication, successfully restored esophageal patency and controlled reflux. At nearly 4 years of follow-up, the child exhibited normal growth and development. This integrated minimally invasive approach may offer a safe and effective alternative for complex esophageal comorbidities that fail conventional therapy, addressing multiple pathologies simultaneously while minimizing surgical trauma.
