Bal Harshjeet Singh, Sen Sudipta
Department of Pediatric Surgery, Christian Medical College, Vellore, India.
Department of Pediatric Surgery, PSG Institute of Medical Science and Rescearch, Coimbatore, Tamil Nadu, India.
J Indian Assoc Pediatr Surg. 2016 Jul-Sep;21(3):116-9. doi: 10.4103/0971-9261.182584.
To evaluate and describe the procedure and outcome of ileocolic replacement of esophagus.
We review 7 children with esophageal injuries, who underwent esophageal replacement using ileocolic segment in Christian Medical College, Vellore, India between 2006 and 2014.
The ileocolic segment was used in 7 children with scarred or inadequate esophagus. There were 4 girls and 3 boys, who underwent esophageal replacement using isoperistaltic ileocolic segment in this period. Age at presentation varied from 1 month to 14 years with an average of 4.6 years. The indications for ileocolic replacements were corrosive strictures in 5, failed esophageal atresia repair in one and gastric volvulus related esophageal stricture in another. The average follow-up duration was 37 months. One child with corrosive stricture lost to follow-up and died 2 years later in another center. Other 6 children were free of dysphagia till the last follow-up.
Although the ileocolic segment is not commonly used for esophageal substitution, it can be useful in special situations where the substitution needs to reach the high cervical esophagus and also where the stomach is scarred and not suitable for gastric pull-up.
评估并描述回结肠代食管的手术过程及结果。
我们回顾了2006年至2014年间在印度韦洛尔基督教医学院接受回结肠段代食管手术的7例食管损伤患儿。
7例食管瘢痕化或长度不足的患儿采用了回结肠段。在此期间,4例为女孩,3例为男孩,均接受了顺蠕动回结肠段代食管手术。就诊时年龄从1个月至14岁不等,平均年龄为4.6岁。回结肠代食管的指征包括5例腐蚀性狭窄、1例食管闭锁修复失败以及1例胃扭转相关的食管狭窄。平均随访时间为37个月。1例腐蚀性狭窄患儿失访,2年后在另一家中心死亡。其他6例患儿直至最后一次随访时均无吞咽困难。
尽管回结肠段不常用于食管替代,但在需要替代至高位颈段食管以及胃瘢痕化不适合行胃上提术的特殊情况下可能有用。