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Órgano Oficial del Instituto Nacional de Pediatría

2008, Número 3

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Acta Pediatr Mex 2008; 29 (3)


A qué edad, qué procedimiento quirúrgico y qué órgano utilizar para sustituir el esófago en caso de atresia esofágica sin fístula: 35 años de experiencia

Vargas-Gómez MA

Idioma: Español
Referencias bibliográficas: 75
Paginas: 129-137
Archivo PDF: 400.57 Kb.


RESUMEN

De 1972 a 2007, se operaron 35 pacientes de sustitución del esófago por atresia esofágica sin fístula, 19 eran recién nacidos menores de seis meses (Grupo A), de los cuales fallecieron tres (21%); los 16 restantes después de los seis meses (Grupo B), de éstos, dos fallecieron (12.5%); la mortalidad global, fue seis de 35 (17.1%). No hubo mortalidad transoperatoria. En 31 pacientes se utilizó el colon para la sustitución y en cuatro el estómago. Se hicieron cinco grupos de procedimientos quirúrgicos del 1 al 5. No hubo muertes en los pacientes operados de los Grupos 1, 4 y 5 (9 pacientes); en el Grupo 2, hubo cuatro muertes de 21 (19%); en el Grupo 3, dos de cinco pacientes (40%). En 14 pacientes que se operaron en los últimos diez años no hubo fallecimientos; fueron operados después de los tres meses de edad, en anabolismo, sin cardiopatía; se emplearon tres de los cinco procedimientos quirúrgicos con colon o estómago. Tuvieron mínimas complicaciones postoperatorias. Conclusión: Aunque se puede realizar con éxito la sustitución del esófago en recién nacidos, lo recomendable es operar después de los tres meses y seleccionar tanto el procedimiento quirúrgico como el órgano para la sustitución.


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