GASTRIC TRANSPOSITION AS AN ESOPHAGEAL REPLACEMENT IN CHILDREN

Dr. LEELA KUMAR VALLAMSETTY; Dr.SARWESWAR REDDY PORLA; Dr.BHUVANESHWAR RAO

Volume : VI, Issue : II, February - 2016

GASTRIC TRANSPOSITION AS AN ESOPHAGEAL REPLACEMENT IN CHILDREN

Dr. Leela Kumar Vallamsetty, Dr. Sarweswar Reddy Porla, Dr. Bhuvaneshwar Rao

Abstract :

RACT Objective : To evaluate our experience with gastric transposition as a method of esophageal replacement in children with congenital or acquired abnormalities of the esophagus. Summary Background Data : Esophageal replacement in children is done for congenital lesions like pure oesaphageal atresia or long gap atresias and acquired lesions like corrosive strictures which requires a conduit that will last more than 70 years. The organ most commonly used in the past has been colon; however, most series have been fraught with major complications and conduit loss. For these reasons, many surgeons switched from using colon interpositions to gastric transpositions for esophageal replacement in infants and children. Methods : We prospectively reviewed 17 patients with the diagnoses of esophageal atresia (n = 15), corrosive injury (n = 2) who underwent gastric transposition for esophageal replacement. Results : Mean ± SE age at the time of gastric transposition was 12–14 months. All transpositions were performed through the retrosternal approach without mortality or loss of the gastric conduit. Complications included esophagogastric anastomotic leak (n = 4), which uniformly resolved without intervention. No redo anastomoses was required. Conclusions : Gastric transposition reestablishes effective gastrointestinal continuity with few complications. Oral feeding and appropriate weight gain are achieved in most children. Therefore, gastric transposition through retrosternal route(as an alternate to transhiatal route) is an appropriate alternative for esophageal replacement in infants and children.