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[Esophageal replacement. 12 years experience].

L F Avila1, A L Luis, J L Encinas

  • 1Departamento de Cirugía Pediátrica, Hospital Infantil Universitario La Paz, Madrid. lfavila73@hotmail.com

Cirugia Pediatrica : Organo Oficial De La Sociedad Espanola De Cirugia Pediatrica
|March 14, 2007
PubMed
Summary

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Pediatric esophageal replacement, though rarely performed, yields good functional results for oral feeding and growth. This major surgery has potential complications, but overall survival remains high.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Thoracic Surgery

Background:

  • Esophageal replacement is a rare surgical procedure in children, indicated for conditions like esophageal atresia and corrosive strictures.
  • Graft type and location are determined by the underlying cause and surgeon preference.

Purpose of the Study:

  • To analyze the outcomes of a significant series of esophageal replacement surgeries performed in children.
  • To evaluate the efficacy and complications associated with different graft types and locations.

Main Methods:

  • Retrospective review of 29 pediatric esophageal replacement cases between January 1992 and December 2004.
  • Patients included those with esophageal atresia, long-gap esophageal atresia, caustic esophagitis, and other rare esophageal conditions.

Related Experiment Videos

  • Colon was used in 86.2% of cases and stomach in 13.8%, with retromediastinal grafts being most common (86.2%).

    • Main Results:

    • All 29 patients achieved a functional graft, tolerating oral feeding and exhibiting normal growth post-surgery.
    • Complications included pyloric obstruction, anastomosis strictures, wound complications, diaphragmatic hernia, and abscesses, necessitating re-operation in 38% of cases.
    • Overall survival was 96.5%, with one mortality due to a mycotic mediastinal abscess.

    Conclusions:

    • Esophageal replacement in children, despite limited indications, leads to satisfactory oral feeding and growth.
    • Both colon and stomach grafts show similar outcomes, though gastric pull-up may be technically simpler.
    • This major surgery carries a significant risk of early postoperative complications.