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Challenges in Anaesthetic management of a child for thoracoscopic assisted oesophageal replacement

K R Chandrakala1, Bindu Nagaraj1, D V Bhagya1

  • 1Department of Paediatric Anaesthesia, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India.

Indian Journal of Anaesthesia
|March 26, 2016
PubMed

Insights

Pediatric esophageal strictures from caustic ingestion may need surgery. Thoracoscopic assisted gastric transposition offers good outcomes but requires careful anesthetic management, especially during one-lung ventilation.

Area of Science:

  • Pediatric surgery
  • Anesthesiology
  • Gastroenterology

Background:

  • Caustic ingestion in children can cause esophageal strictures, leading to loss of esophageal length or lumen obliteration.
  • Surgical reconstruction is often necessary for severe cases.
  • Thoracoscopic assisted gastric transposition is a preferred method for esophageal replacement in pediatric patients.

Purpose of the Study:

  • To describe the anesthetic management of a pediatric patient undergoing thoracoscopic assisted gastric transposition for esophageal stricture.
  • To highlight the anesthetic challenges associated with this procedure in children.

Main Methods:

  • Case report of an 8-year-old boy with esophageal stricture post-corrosive injury.
  • Procedure: Thoracoscopic assisted gastric transposition.
  • Anesthetic management focused on pre-operative evaluation, preparation, and intra-operative care, including one-lung ventilation (OLV).

Main Results:

  • The case highlights the feasibility of thoracoscopic assisted gastric transposition in children.
  • Successful anesthetic management was achieved despite the procedure's complexity and the need for OLV.
  • The report emphasizes the importance of meticulous anesthetic planning for minimally invasive esophageal reconstruction.

Conclusions:

  • Thoracoscopic assisted gastric transposition is an effective treatment for pediatric esophageal strictures.
  • Careful anesthetic management, particularly regarding one-lung ventilation, is crucial for successful outcomes.
  • This approach offers a minimally invasive option for complex pediatric esophageal reconstruction.

Keywords:
Anesthesiaoesophageal replacementpediatric thoracoscopyvideo-assisted thoracoscopic surgery

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