Alvarado-García R, Jiménez-Urueta PS, Ávila-Zaragoza M

Language: Spanish
References: 14
Page: 322-325
PDF size: 40.66 Kb.

ABSTRACT

Introduction: The colon is widely used to date as a substitute of the esophagus because it is the organ from which best results have been obtained. This presentation’s objective was to show analysis of 15 cases with esophageal atresia without fistula (AESF) operated on for colonic interposition by retrosternal via and compared results in patients with thoracotomy performed priour to interposition and those without it. Material and methods: Clinical records were reviewed with AESF operated on for esophageal substitution from 1980 to 2000, analyzing variables at the operation moment (age, sex, colon segment used, complications) and after one year of follow-up (contrasted studies and endoscopy). Results: There was a remarkable difference between patients with previous thoracotomy (group 2) and those who did not undergo this surgery (group 1). In general, 47% were reoperated on; of these, 86% corresponded to group 2. Group 2 presented a higher percentage of stenosis (33%), fistulas (27%), and reflux (6%) in comparison with group 1 in which stenosis (20%), fistula (13%), and reflux (6%) were found. In follow-up of 12 months, group 1 had no alterations in 89%; in group 2, 50% had gastrocolic reflux, 33% had retarded gastric emptying, and 17%, stenosis. Discussion: Detailed study of the patient with AESF, to determine length of both esophagus segments must preceed the decision to perform thoracotomy with the finality of restoring continuity.

REFERENCES

1. Von Hacker V. On esophagoplasty in general and on the repair of the esophagus by antethoracic construction of a skin-colon tube in particular. Arc Klin Chir 1914;105:973.

2. Dale WA, Sherman CD. Late reconstruction of congenital esophageal atresia by intrathoracic colon transplantation. J Thorac Surg 1955; 29:344.

3. Othersen HB Jr, Clarworthy HW Jr. Functional evaluation of esophageal replacement in children. J Thorac Cardiovasc Surg 1967;53:55-58.

4. Freeman NV, Cass DT. Colon interposition: a modification of the Waterson technique using the normal esophageal route. J Pediatr Surg 1982;17:17-21.

5. Guitrona A, Mena G, Gutiérrez JA, Olivares V. Estenosis esofágica benigna en pacientes lactantes y preescolares. Resultados de dilatación endoscópica. Rev Gastroenterol Mex 1999;64(1):12-15.

6. Mitchel IM. Colon interposition in children. Br J Surg 1989;76: 681-686.

7. Caneiro PM, Doig CM. Colon interposition for wide gap oesophageal atresia. East Afr Med J 1993;70(3):682-685.

8. Raffensperger JG. Intestinal bypass of the esophagus. J Pediatr Surg 1996; 31:38-42.

9. Schumpelick V, Dreuw B, Ophoff K, Fass J. Esophageal replacement-indications, technique, results. Leber Magen Darm 1995; 25(1):21-26.

10. West KW, Vane DW, Grosfeld JL. Esophageal replacement in children: experience with thirty one cases. Surgery 1986;100(5):751-757.

11. De Peppo B, Zaccara A, Dall’Ogllio L, Federici G, Ponticelli A. Stenting for caustic strictures: esophageal replacement replaced. J Pediatr Surg 1998;33(1):54-57.

12. Alvarado AR, Jiménez UP, Gallego GG, Sollano CL, Gutiérrez CP. Interposición de colon retroesternal en niños. Análisis de 33 casos. Acta Pediatr Mex 2002;23(3):139-143.

13. González ZJF, Villegas AF. Atresia de esófago: morbiletalidad en el INP (1971-1999). Acta Pediatr Mex 2001;22(6):411-418.

14. Sagols MG, Vargas GM, Ramírez MJ, Cervantes BR, Mata RN. Condiciones clínicas y funcionales a largo plazo de pacientes operados de interposición colónica. Acta Pediatr Mex 2001;22(5):357-360.