Evaluation of an antireflux procedure for colonic interposition in pediatric esophageal replacements.

Détails

ID Serval
serval:BIB_004B2F6FA4E8
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Evaluation of an antireflux procedure for colonic interposition in pediatric esophageal replacements.
Périodique
Journal of Pediatric Surgery
Auteur⸱e⸱s
Vasseur Maurer Sabine, Estremadoyro Vanina, Reinberg Olivier
ISSN
1531-5037 (Electronic)
ISSN-L
0022-3468
Statut éditorial
Publié
Date de publication
2011
Volume
46
Numéro
3
Pages
594-600
Langue
anglais
Résumé
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.
Mots-clé
Esophageal replacement, Gastrocolic reflux, Antireflux wrap, Children, children, reconstruction, strictures, experience
Pubmed
Web of science
Création de la notice
31/03/2011 13:23
Dernière modification de la notice
20/08/2019 12:22
Données d'usage