AN UNSUTURED MESENTERY DEFECT AFTER COLON GRAFT FORMATION IN ESOPHAGOPLASTY IN CHILDREN

Abstract

Purpose. To decrease the number of complications at the intra-abdominal stage of total esophagoplasty in children by leaving a mesentery defect unsutured after the graft formation. Material and methods. 27 children with atresia (4) and scar contraction (23) of the esophagus had esophagoplasty with a colon left-side graft on a vascular pedicle including a. colicamed; a.colicasin and the arcade between the first sigmoid artery were ligated and cut. The graft was placed behind the sternum in the antiperistaltic position. A “window” in the mesentary of the transverse colon was left unsutured after the graft formation. Basic techniques for examination - X-ray and endoscopy. An anastomosis “end of the esophagus to the side of the colon graft” was always formed at the neck level. Results. Due to the unsutured mesentary of the transverse colon, surgeons avoided all intra-abdominal complications which may develop, if the mesentary is sutured. The right side of the colon remained intact ; neck-anastomosis fistulas were seen only in 2 (9%) patients.