Department of Pediatric Surgery, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey.
Afr J Paediatr Surg. 2020 Jul-Dec;17(3 & 4):45-48. doi: 10.4103/ajps.AJPS_95_17.
Oesophageal colonic interposition in oesophageal atresia (OA) patients is almost exclusively done as a staged operation with an initial oesophagostomy and gastrostomy followed by the definitive surgery months later. This study presents a series of patients in whom a cervical oesophagostomy was not performed before the substitution surgery.
Records of EA patients were evaluated for those who underwent colon interposition without cervical oesophagostomy.
There were five patients: three with pure EA and two with proximal tracheo-oesophageal fistula. A delayed primary repair could not be performed because of intra-abdominally located distal pouch. The mean age at the time of definitive operation was 5.54 (±2.7) months and the mean weight was 6.24 (±1.3) kg. A right or a left colonic segment was used for interposition keeping the proximal anastomosis within the thorax. The post-operative results were quite satisfactory within a median follow-up period of 33.2 months.
Avoiding cervical oesophagostomy and its inherent complications and drawbacks is possible in a subset of patients with long-gap EA who underwent colonic substitution surgery. This approach may be seen as an extension of the consensus that the native oesophagus should be preserved whenever possible, because it uses the native oesophagus in its entirety.
食管闭锁（OA）患者的结肠间置术几乎都是分期进行的，先进行食管胃造口术和胃造口术，几个月后再进行确定性手术。本研究介绍了一组在替代手术前未行颈段食管造口术的患者。
评估了接受结肠间置术而未行颈段食管造口术的 EA 患者的记录。
共有 5 例患者，其中 3 例为单纯性 EA，2 例为近端气管食管瘘。由于腹腔内有远端囊袋，无法进行延迟性一期修复。确定性手术时的平均年龄为 5.54（±2.7）个月，平均体重为 6.24（±1.3）kg。使用右或左结肠段进行间置，将近端吻合口保留在胸腔内。在中位随访 33.2 个月内，术后结果相当满意。
对于接受结肠替代手术的长段 EA 患者亚组，避免颈段食管造口术及其固有并发症和缺点是可能的。这种方法可以看作是共识的延伸，即只要可能，就应保留固有食管，因为它完全使用固有食管。
