Abstract
Introduction. The authors analyze the effectiveness of one-stage esophageal plasty in children. They consider -from different points of view- possible problems accompanying such surgical interventions as well as complications and high mortality.Material and methods. The article summarizes outcomes after esophagoplasty in 61 patient who were at the surgical department of the Center for Pediatrics and Pediatric Surgery (Almaty, Kazakhstan) during 2006–2020 (June). Among them there were 24 (38%) children after the first stage of cervical esophagostomy combined with gastrostomy in esophageal atresia; 34 (56%) children had decompensated post-burn esophageal stricture and after ineffective conservative treatment; 1 (2%) patient had esophageal varicose veins because of the portal hypertension syndrome with formed cicatricial esophageal stricture and with high risk for bougienage; 2 (4%) patients had an extended peptic stricture of the esophagus as a complication of gastroesophageal reflux disease (Barrett esophagus).Results. One-stage coloesophagoplasty was performed in 44 (72%) children. Gastroesophagoplasty with the whole stomach transposition was performed in 12 (20%) children with esophageal atresia; in 3 (5%) - replacement for post-burn cicatricial stenosis and in 1 (2%) - because of varicose veins in the esophagus.Conclusion. The choice of esophagoplasty technique should be individualized depending on patient’s general state, on pathological lesions in the esophagus as well as on previous surgeries on the abdominal organs, if any.
Highlights
The authors analyze the effectiveness of one-stage esophageal plasty in children
Среди них 24 (38%) ребёнка после первого этапа наложения цервикальной эзофагостомы в сочетании с гастростомией при атрезии пищевода; 34 (56%) с декомпенсированной постожоговой стриктурой пищевода и неэффективностью консервативного лечения; 1 (2%) с варикозным расширением вен пищевода на фоне синдрома портальной гипертензии со сформировавшейся рубцовой стриктурой пищевода и высоким риском для бужирования; 2 (4%) с протяженной пептической стриктурой пищевода – осложнение гастроэзофагеальной рефлюксной болезни
Among them there were 24 (38%) children after the first stage of cervical esophagostomy combined with gastrostomy in esophageal atresia; 34 (56%) children had decompensated post-burn esophageal stricture and after ineffective conservative treatment; 1 (2%) patient had esophageal varicose veins because of the portal hypertension syndrome with formed cicatricial esophageal stricture and with high risk for bougienage; 2 (4%) patients had an extended peptic stricture of the esophagus as a complication of gastroesophageal reflux disease (Barrett esophagus)
Summary
АО «Научный Центр педиатрии и детской хирургии» МЗ, 050040, Алматы, Республика Казахстан. Эффективные методы одноэтапной пластики пищевода у детей, которые учитывают сложность этих операций, осложнения и высокую смертность, рассматриваются с различных точек зрения. В статье обобщен анализ результатов эзофагопластики пищевода 61 пациента, которые находились в отделении хирургии Научного центра педиатрии и детской хирургии г. Алматы за период с 2006 по 2020 (июнь) г. Одномоментная колоэзофагопластика выполнена у 44 (72%) детей. Гастроэзофагопластика транспозицией целым желудком применена у 12 (20%) детей с атрезией пищевода, у 3 (5%) – заменапо поводу постожогового рубцового стеноза, и у 1 (2%) в результате варикозного расширения вен пищевода. Выбор метода эзофагопластики у больных должен быть индивидуальным, с учетом общего состояния пациента, наличия патологического поражения пищевода, а также характера ранее выполненных операций на органах брюшной полости.
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