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[Esophagogastroplasty in childhood: experience in 4 patients]
J Llorente1, V Martínez Ibáñez, M Asensio
1Hospital Universitario Materno-Infantil Vall d'Hebron, Barcelona.
Insights
Total gastric transposition is an effective surgical option for pediatric esophageal replacement due to long-gap esophageal atresia and caustic strictures. This technique offers good functional outcomes with low morbidity in children.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Thoracic Surgery
Background:
- Esophageal replacement in children is commonly indicated for long-gap esophageal atresia and caustic strictures.
- Various surgical techniques utilize different digestive tract components for esophageal reconstruction.
Purpose of the Study:
- To evaluate the efficacy and outcomes of total gastric transposition in pediatric patients requiring esophageal replacement.
Main Methods:
- Total gastric transposition was performed in 4 pediatric patients.
- Indications included esophageal atresia without tracheoesophageal fistula (3 cases) and caustic stricture (1 case).
- Follow-up ranged from 12 to 32 months.
Main Results:
- All 4 patients achieved normal feeding post-operatively.
- One patient experienced an anastomotic leak, successfully managed with total parenteral nutrition, but developed a subsequent anastomotic stricture requiring pneumatic dilatation.
- Another patient required surgical repair for a stricture caused by sternal compression.
Conclusions:
- Total gastric transposition is presented as a straightforward and physiological technique for esophageal replacement in children.
- The procedure demonstrates low morbidity and favorable functional results in the studied cohort.
Abstract:
The most common indications of esophageal replacement in childhood are the esophageal atresia with long gap and caustic strictures. Several techniques has been described, using different components of the digestive tract. Total gastric transposition was performed in 4 children. The indications were esophageal atresia without tracheoesophageal fistula in 3 cases and a caustic stricture in other patient. Follow-up was 12 to 32 months. All patients are normally feed. One patient presented an anastomotic leak that closed spontaneously with total parenteral nutrition but ultimately led to an anastomotic stricture requiring pneumatic dilatation. Other patient presented stricture by sternal compression and required surgical repair. Total gastric transposition is a easy and physiologic technique, with low morbidity and good functional results.