Evaluation of an anti-reflux procedure for colonic interposition in pediatric esophageal replacements

Details

Serval ID
serval:BIB_C693FB3095E7
Type
Article: article from journal or magazin.
Collection
Publications
Title
Evaluation of an anti-reflux procedure for colonic interposition in pediatric esophageal replacements
Journal
J Pediatr Surg
Author(s)
Vasseur Maurer Sabine, Estremadoyro Vanina, Reinberg Olivier
Publication state
Published
Issued date
11/2011
Peer-reviewed
Oui
Volume
46
Number
11
Pages
594-600
Language
english
Notes
Prix de l'Association vaudoise des femmes diplômées des Universités au Dr Sabine Vasseur Maurer
Abstract
Background: In 1989, we introduced a 1-stage procedure with orthotopic colonic transplants for esophageal stenosis. A pitfall of this procedure is frequent reflux and/or stasis in the transplants from the cologastric anastomosis. Since 1993, we have used a new antireflux wrap (ARW) using an anterior wrap technique similar to the Dor procedure but fixed to the right crus of the diaphragm.
Purpose: The purpose of the study was to evaluate ARWs.
Method: From 1993 to 2008, the records of 67 patients with an ARW were compared with 27 without ARW (either operated on before 1993 or ARW was not appropriate) after colonic transplant for caustic esophageal stenosis. Both groups otherwise underwent the same surgical procedure. Postoperative esophagograms done on postoperative day 10 were reviewed for the presence of gastrocolonic reflux and stasis in the transplant.
Results: The reflux rate on the initial esophagogram was reduced from 48.1% to 7.5% using ARW. The incidence of reflux on later esophagograms was 40.0% with no ARW and 21.4% with ARW. The 25% long-term rate of stasis in the colonic transplant was not increased with ARW.
Conclusions: A loose ARW in patients with colonic esophageal replacements reduces gastrocolic reflux without increasing the rate of stasis. In the long term, children adapt better to stasis than to reflux and are thus protected from occult inflammation.
Keywords
esophageal replacement, corrosive strictures.
Pubmed
Create date
22/07/2010 15:16
Last modification date
20/07/2020 8:30
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