Esophageal replacement in children: 10 years' experience.

Esophageal replacement continues to be a challenging surgical problem. Currently advocated methods entail using reversed gastric tube or colon for the interposition. Between 1969 and 1978, 11 children underwent esophageal reconstruction. Their ages at operation ranged from 1 to 16 years. All the operations were performed in one stage. The right colon was used in seven children and reversed gastric tube in four. There were no postoperative deaths. Temporary salivary fistula and cervical anastomotic stricture were the most common operation-related complications. On the follow-up visit, at least six months after surgery, all the children were able to eat a normal diet. The use of reversed gastric tube avoids intestinal resection, preserves the ileocecal valve, shortens the operative period and preserves the possibility of an alternative procedure (colon interposition) if technical failure occurs. On the basis of our limited experience we advocate the use of reversed gastric tube for esophageal replacement.