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Complications after gastric transposition in children
D J Macksood1, C E Blane, R A Drongowski
1Department of Pediatric Radiology, University of Michigan Medical Center, C.S. Mott Children's Hospital, Ann Arbor 48109-0252, USA.
Insights
Pediatric patients undergoing esophagogastrostomy with gastric transposition for esophageal atresia experienced fewer complications than adults. Benign stricture was the most frequent issue, occurring early and late post-surgery.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Congenital Abnormalities
Background:
- Esophagogastrostomy with gastric transposition is increasingly utilized for esophageal atresia repair in children.
- Limited data exists comparing postoperative complications in pediatric versus adult populations.
Purpose of the Study:
- To compare the incidence and types of postoperative complications in children who underwent esophagogastrostomy with gastric transposition for esophageal atresia against those reported in adult literature.
Main Methods:
- Retrospective review of medical records and radiologic images for 6 pediatric patients (5 male, 1 female) who had esophagogastrostomy with gastric transposition.
- Follow-up duration ranged from 18 months to 12 years.
- Complications were compared with published adult data.
Main Results:
- Complications were categorized as early (≤1 month) or late (>1 month).
- Observed complications included anastomotic leak (1 patient), hernia (1 patient), and recurrent stricture (3 patients).
- One patient developed a mediastinal abscess due to esophageal perforation during stricture dilation.
Conclusions:
- Postoperative complications following gastric transposition are less frequent in children compared to adults.
- Benign stricture represents the most common complication, with potential for both early and late onset.
Background And Objective:
Esophagogastrostomy with gastric transposition, a procedure for replacement of the esophagus in cases of esophageal atresia, is increasing in popularity among pediatric surgeons. This study was undertaken to document the differences between postoperative complications in children and those reported in adults.
Patients And Methods:
The authors reviewed the medical records and radiologic images for details of complications in 6 children (5 boys and 1 girl) who underwent esophagogastrostomy with gastric transposition for esophageal atresia. Follow-up ranged from 18 months to 12 years. The observations were compared with complications in adults, as reported in the literature.
Results:
The complications of gastric transposition were classified as early (up to 1 month after surgery) of late (more than 1 month after surgery). They included anastomotic leak (in 1 patient), hernia (in 1) and recurrent structure (in 3). In 1 patient mediastinal abscess developed secondary to esophageal perforation, which occurred during a dilation procedure for stricture.
Conclusions:
Postoperative complications of gastric transposition occur less commonly in children than in adults. Benign stricture, which may occur both early and late, is the most common problem.