Esophageal Replacement With Colon Interposition in Children

Background The indications of esophageal replacement in pediatric patients include long gap esophageal atresia, intractable post-corrosive esophageal strictures, and some rare esophageal diseases. Colon interposition is the time-tested procedure with minimal and less serious complications. Methods From 2019–2023 111 children, who required esophageal plastic surgery were operated on in the thoracic surgical department. Among them, there were 50 (45%) children with esophageal atresia, 54 (48,6%) with cicatricial esophageal stenosis 5 (4,5%) with peptic stenosis of the esophagus, 2 (1,9%) with esophageal tumor. The age of the children varied from 6 months to 17 years, body weight—from 7,5 to 50 kg. All patients underwent retrosternal colon interposition The effectiveness was determined according to the criteria of normalization of oral feeding, the physical development of the child and the degree of his social adaptation. Results A cervical fistula formed in 28 (25,2%) patients, which closed within 1 month after surgery. In 9 (8,1%) patients, stenosis of the esophagocoloanastomosis developed. Witch teikar the method of balloon dilatation (1–4 procedures); in 3 cases, reconstruction of esophagocoloanastomosis was performed with a positive outcome. In 2 (1,8%) patients, within a year after surgery, dysfunction and chronic obliteration of the graft occurred, which required its removal and repeated esophageal plasty. 1 patient underwent repeated coloesophagoplasty from the right parts of the colon on the middle colon vessels, in another patient, esophagoplasty with the stomach was performed. Conclusion Colon interposition of esophagus is the optimal way to replace the esophagus in children, which allows not only to restore the integrity of the upper gastrointestinal tract, but also to ensure adequate feeding of the child and achieve full social adaptation.