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Related Experiment Videos

Save the child's esophagus, Part II: Colic patch repair

H B Othersen1, E F Parker, J Chandler

  • 1Division of Pediatric Surgery, Medical University of South Carolina, Children's Hospital, Charleston 29425, USA.

Journal of Pediatric Surgery
|February 1, 1997
PubMed
Summary
This summary is machine-generated.

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Vascular colic patches offer a viable alternative for treating severe esophageal strictures in children, preserving the esophagus. However, ongoing reflux or Barrett's esophagus may necessitate reoperation due to scarring and obstruction.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Thoracic Surgery

Background:

  • Esophageal reconstruction in children presents unique challenges.
  • Previous methods for severe esophageal disruption involved resection and interposition.
  • Preserving esophageal integrity is crucial for long-term patient outcomes.

Purpose of the Study:

  • To evaluate the feasibility of using a vascularized esophageal patch in older children.
  • To present a modified "colonic-patch oesophagoplasty" technique.
  • To assess the efficacy of this technique in repairing esophageal strictures and fistulae.

Main Methods:

  • A modified colonic-patch oesophagoplasty was performed on 14 children; one received an intercostal muscle flap.
  • The procedure involved esophagotomy through the stricture, followed by patch application.

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  • Patients ranged from 8 months to 16 years, with strictures caused by various etiologies.

    • Main Results:

    • Excellent results were observed in nine patients (colic patch) with good swallowing.
    • One patient with an intercostal muscle flap showed good initial results.
    • Three patients had good results with occasional swallowing difficulties or reflux; two had poor results requiring reoperation.

    Conclusions:

    • Vascular colic patches are a viable alternative to esophageal resection for severe strictures.
    • Continuing reflux or Barrett's esophagus can lead to distal scarring and obstruction, potentially requiring reoperation.
    • Careful patient selection and monitoring are essential for optimal outcomes.