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Oesophageal replacement in paediatric patients

M A Aghaji1, O C Chukwu

  • 1Cardiothoracic Unit, University of Nigeria Teaching Hospital, Enugu.

Journal of the Royal College of Surgeons of Edinburgh
|April 1, 1992
PubMed

Insights

Pediatric patients with undilatable esophageal strictures tolerated esophageal replacement using colonic conduits well. This surgical approach demonstrated good short- and medium-term outcomes for children with corrosive esophageal burns.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Thoracic Surgery

Background:

  • Undilatable esophageal strictures in children often result from accidental corrosive burns.
  • Esophageal replacement is a complex procedure in pediatric patients.

Purpose of the Study:

  • To evaluate the safety and efficacy of isoperistaltic colonic conduit for esophageal replacement in children with undilatable strictures.
  • To assess short- and medium-term outcomes and complications associated with this procedure.

Main Methods:

  • A cohort of 24 children (aged 16 months to 12 years) underwent esophageal replacement with an isoperistaltic colonic conduit between January 1986 and December 1990.
  • All strictures were secondary to accidental corrosive ingestion.
  • Patients were monitored for postoperative complications and functional outcomes, including swallowing ability.

Main Results:

  • The procedure was well-tolerated, with all patients achieving the ability to swallow within 3 weeks post-surgery.
  • No operative or postoperative deaths occurred.
  • Major complications included pneumothorax (2 cases), Ascaris lumbricoides-induced gastric outlet obstruction (2 cases), and cervical fistulas (8 cases) that resolved spontaneously.

Conclusions:

  • Esophageal replacement with isoperistaltic colonic conduit is a viable and well-tolerated option for children with undilatable esophageal strictures.
  • The procedure offers good short- and medium-term results, though long-term concerns regarding the native esophagus remain.
  • This technique provides a safe alternative for managing severe esophageal damage in pediatric populations.

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