Total gastric transposition: An alternative to esophageal replacement in children

Marujo, Wagner; Tannuri, Uenis; Maksoud, João Gilberto

doi:10.1016/0022-3468(91)90009-i

Cited by 42 publications

(36 citation statements)

References 33 publications

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“…Of these, high success rates were reported mainly when jejunum, colon, or stomach were used as conduits. [3][4][5][6][7][8] Nevertheless, these operations are lengthy and demanding and carry a considerable incidence of complications, 21 and a search for an alternative surgical procedure is warrented. Previous studies have shown clearly that blood supply to different tissues may be markedly augmented by omentopexy.…”

Section: Discussionmentioning

confidence: 99%

“…To avoid these complications, esophageal substitute operations have been used and currently are the most commonly used technique for the surgical management of pathologic processes involving the esophagus. [3][4][5][6][7][8] This is undoubtedly the best option for pathologies involving a large portion of the esophagus, but when only a short segment of the thoracic esophagus is diseased, the attempt to perform primary end-to-end anastomosis to save the native esophagus is appealing. This could only be considered if the ischemic complications could be overcome by a method that will enhance anastomotic vascularization.…”

mentioning

confidence: 99%

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Omentopexy improves vascularization and decreases stricture formation of esophageal anastomoses in a dog model

Hayari

Hershko

Shoshani

et al. 2004

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Omentopexy improves vascularization and decreases stricture formation of esophageal anastomoses in a dog model

Hayari

Hershko

Shoshani

et al. 2004

Journal of Pediatric Surgery

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“…Colonic interposition has traditionally been the most popular method in children [9][10][11]. However, the technical challenges of colonic interposition and complications such as short-term graft loss and long-term graft dysfunction have led some investigators to attempt alternative procedures [9,[12][13][14][15].…”

Section: Familial Massive Leiomyoma E31mentioning

confidence: 99%

Familial massive leiomyoma with esophageal leiomyomatosis: an unusual presentation in a father and his 2 daughters

Lee

Nance

Kaiser

et al. 2005

Journal of Pediatric Surgery

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“…Various interposition grafts have been utilised including colon [9], gastric tube oesophagoplasty [10], gastric transposition [11] and jejunum [1]. The jejunum has a similar diameter to the oesophagus and therefore it occupies less space within the thoracic cavity than the stomach.…”

Section: Discussionmentioning

confidence: 99%

Oesophageal substitution with free and pedicled jejunum: short- and long-term outcomes

et al. 2006

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In children, the indications for oesophageal substitution are principally, long gap oesophageal atresia (OA), severe anastomotic disruption following primary repair of OA and severe caustic or peptic strictures. We present an outcome review of eight cases who underwent oesophageal substitution with jejunum at our institution between 1986 and 2001. The purpose of this study was to evaluate our experience with free/pedicled jejunal grafts and its long-term outcome as an oesophageal substitute. Operative and postoperative outcome with free and pedicled jejunal grafts in four cases of pure OA, two cases of OA and distal tracheo-oesophageal fistula (TOF), one patient with a high retrolaryngeal oesophageal web and one case of severe caustic oesophageal stricture. Six patients had an oesophagostomy and a gastrostomy fashioned previously. Eleven free jejunal grafts were performed in six patients (three intraoperative redo interpositions for immediate graft loss, three separate grafts in one patient and two free grafts in two patients). One patient's pedicled jejunal graft proximally required microvascular anastomosis while the other had a pedicled graft without microvascular anastomosis. Early postoperative complications included four upper anastomotic leaks (three free grafts, one pedicled with microvascular support), pneumothorax requiring prolonged ventilation and Horner's syndrome. Recurrent laryngeal nerve injury occurred in the patient who had a high retrolaryngeal oesophageal web. During follow up (5-18 years) late complications of upper anastomotic stricture in four patients and graft redundancy with subsequent kinking of the lower anastomosis were observed in one patient. Three patients established a complete oral diet; a further three patients relied on supplemental gastrostomy feeds and one patient is entirely gastrostomy fed. There were two late deaths, one from aspiration and the other from a severe asthmatic attack (5 and 7 months postoperatively, respectively). Our results indicate that there are significant complications related to the use of free jejunal grafts. Early recognition and treatment are of paramount importance in the ultimate achievement of a successful technical outcome.

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Total gastric transposition: An alternative to esophageal replacement in children

Cited by 42 publications

References 33 publications

Omentopexy improves vascularization and decreases stricture formation of esophageal anastomoses in a dog model

Omentopexy improves vascularization and decreases stricture formation of esophageal anastomoses in a dog model

Familial massive leiomyoma with esophageal leiomyomatosis: an unusual presentation in a father and his 2 daughters

Oesophageal substitution with free and pedicled jejunum: short- and long-term outcomes

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