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
Summary
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.
- 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.