Esophageal replacement in children who have caustic pharyngoesophageal strictures
| Autor: | Carlo Buonomo, W. Hardy Hendren, Joseph Upton, Dennis P. Lund, Craig W. Lillehei, Gerald B. Healy, Rosa S Choi |
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| Rok vydání: | 1997 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Colon medicine.medical_treatment Anastomosis Surgical Flaps Burns Chemical medicine Paralysis Humans Esophagus Child Esophageal disease business.industry Stomach Anastomosis Surgical Pharynx Transverse colon Infant Pharyngeal Diseases General Medicine medicine.disease Surgery Esophagectomy medicine.anatomical_structure Child Preschool Pediatrics Perinatology and Child Health Esophageal Stenosis Female medicine.symptom business |
| Zdroj: | Journal of Pediatric Surgery. 32:1083-1088 |
| ISSN: | 0022-3468 |
| Popis: | Caustic injury to the upper aerodigestive system with scarring of the pharynx, hypopharynx, and esophagus is a challenging reconstructive problem. The authors report on seven patients who required total esophageal replacement from the pharynx to the stomach. Injury occurred from alkali in six and acid in one. Age at injury ranged from 14 months to 14 years (mean, 4.5 years.) in five boys and two girls. Time from injury to esophageal replacement was 6 months to 10 years (mean, 3.5 years). Two required pharyngeal reconstruction before and one after esophageal replacement. Six patients had an isoperistaltic right or transverse colon interposition. One who had gastric necrosis had an ileo-right colonic substernal interposition with creation of a jejunal reservoir. Results of barium swallows showed intact anastomoses in all patients. There were no leaks. Most had some degree of mild to moderate aspiration, and one who had left vocal cord paralysis had initially massive aspiration. Three patients currently eat regular diets; four eat but still require supplemental tube feeds. The authors conclude that children who have hypopharyngeal scarring and obliterated esophageal inlet can undergo a successful colonic esophageal replacement with high proximal pharyngocolic anastomosis. |
| Databáze: | OpenAIRE |
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