Taher Heba, Amgad Ahmed, Magdi Andrew, Magdy Ahmed, Tantawi Hytham Esmate El, Kaddah Sherif N, Tawfik Sherifa, Tarek Mahmoud, Abdullateef Khaled S
Department of Pediatric Surgery, Cairo University, Cairo, Egypt.
Faculty of Medicine, Helwan University, Cairo, Egypt.
Esophagus. 2025 Jul;22(3):467-474. doi: 10.1007/s10388-025-01114-x. Epub 2025 Apr 8.
This study evaluates the outcomes of transhiatal colon bypass, with or without esophagectomy, as a surgical intervention for esophageal replacement in pediatric patients with severe corrosive esophageal strictures, focusing on safety, complications, and long-term functional outcomes.
A retrospective analysis was conducted on pediatric patients who underwent transhiatal colon bypass between 2016 and 2019. The study included cases both with and without simultaneous esophagectomy. Standardized follow-up protocols were used to monitor complications, mortality, and long-term outcomes.
Ten pediatric patients were included, with seven undergoing esophagectomy as part of the transhiatal colon bypass. The esophagectomy group had a significantly longer operative time (6.0 ± 0.7 h vs. 5.0 ± 0.4 h, p = 0.02). Intraoperative complications included vagus nerve injury (2 cases) and one intraoperative death. Postoperative issues included pneumonia (2 cases) and anastomotic leaks (2 cases). Long-term complications included anastomotic strictures and one case of intestinal obstruction. Despite these complications, both groups showed normal growth and good functional outcomes, with no significant differences in manometric results (p = 1.00).
Transhiatal colon bypass is a safe and effective option for esophageal replacement in pediatric patients with corrosive esophageal strictures. While esophagectomy increases surgical complexity and risks, it may be necessary in cases where the native esophagus poses long-term risks. Intraoperative assessment is crucial in deciding whether to include esophagectomy.
本研究评估经裂孔结肠旁路术（无论是否联合食管切除术）作为一种手术干预手段，用于患有严重腐蚀性食管狭窄的儿科患者食管替代的效果，重点关注安全性、并发症和长期功能结果。
对2016年至2019年间接受经裂孔结肠旁路术的儿科患者进行回顾性分析。该研究包括同时进行和未进行食管切除术的病例。采用标准化的随访方案来监测并发症、死亡率和长期结果。
纳入了10名儿科患者，其中7名在经裂孔结肠旁路术时进行了食管切除术。食管切除组的手术时间明显更长（6.0±0.7小时对5.0±0.4小时，p = 0.02）。术中并发症包括迷走神经损伤（2例）和1例术中死亡。术后问题包括肺炎（2例）和吻合口漏（2例）。长期并发症包括吻合口狭窄和1例肠梗阻。尽管有这些并发症，但两组均显示生长正常且功能结果良好，测压结果无显著差异（p = 1.00）。
经裂孔结肠旁路术是患有腐蚀性食管狭窄的儿科患者食管替代的一种安全有效的选择。虽然食管切除术会增加手术复杂性和风险，但在原生食管存在长期风险的情况下可能是必要的。术中评估对于决定是否进行食管切除术至关重要。
