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Órgano Oficial del Instituto Nacional de Pediatría

2008, Number 3

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Acta Pediatr Mex 2008; 29 (3)

At what age, which surgical procedure, and which organ to use for esophagus substitution in esophageal atresia without fistula: 35 years experience

Vargas-Gómez MA

Language: Spanish
References: 75
Page: 129-137
PDF size: 400.57 Kb.


ABSTRACT

From 1972 to 2007 35 patients with esophageal atresia without fistulae were operated for substitution of the esophagus. Nineteen were children under six months of age (Group A), six (21%) of which died. The remaining 16 were over six months of age at operation (Group B), two of which (12.5%) died. Overall fatalities numbered five (17.1%). There were no deaths during surgery. In 31 patients the colon was used for substitution and the stomach in four. Surgical procedures were divided into five groups from 1 to 5. There were no deaths in Groups 1, 4 and 5 (nine patients). There were four deaths out of 21 patients (19%) in Group 2 and two deaths out of five patients (40%) in Group 3. There were no fatalities in 14 patients over three months of age operated in the last ten years; these were patients in anabolism, without heart disease. Three surgical procedures were used either with colon or with stomach replacement. They sustained minimal complications. Conclusion: Esophageal substitution can be performed in neonates but it is best to operate after three months of age provided the right surgical procedure and organ for replacement are chosen.


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