Laparoscopically assisted transhiatal esophagectomy with esophagogastroplasty for post-corrosive esophageal stricture treatment in children

Pediatr Surg Int. 2007 Jun;23(6):545-9. doi: 10.1007/s00383-007-1888-8. Epub 2007 Mar 9.

Abstract

A tight post-corrosive esophageal stricture in a child poses significant surgical challenges. Many studies have described minimally invasive esophagectomy in adults, but very few reports have described this technique in children. Minimally invasive esophagectomy represents a new alternative to conventional open esophagectomy. This retrospective study evaluated the safety and efficacy of laparoscopically assisted transhiatal esophagectomy and gastric transposition for post-corrosive esophageal stricture treatment. Twenty-seven children with post-corrosive esophageal stricture were subjected to this technique. Their ages ranged from 3 to 13.5 years (mean 5.6 years). Fourteen were females and thirteen were males. None of the procedures needed to be converted to an open approach, and there were neither intra-operative complications nor increased blood loss. Left-sided pneumothorax occurred in one case only (3.7%). The mean operating time was 160 min (range 120-180). Three patients were admitted postoperatively to intensive care unit for a period of 48 h for assisted ventilation. Mean hospital stay was 4 days (range 3-7 days). Anastomotic leakage occurred in three patients (11.1%), while anastomotic stricture occurred in four patients (14.8%). About 93.5% of our cases have achieved excellent results. Post-operative nutritional status was satisfactory and accepted. Laparoscopically assisted transhiatal esophagectomy and gastric transposition for post-corrosive esophageal stricture treatment in children is safe, visible, effective, and an accepted operative technique. The cosmetic result is excellent.

MeSH terms

  • Adolescent
  • Burns, Chemical / complications*
  • Child
  • Child, Preschool
  • Egypt
  • Esophageal Stenosis / chemically induced
  • Esophageal Stenosis / surgery*
  • Esophagectomy / methods*
  • Female
  • Gastroplasty / methods*
  • Humans
  • Laparoscopy / methods*
  • Male
  • Minimally Invasive Surgical Procedures
  • Retrospective Studies
  • Treatment Outcome