State of the Art: Reconstruction of the Esophagus in Less Than One Year Old Infants

摘要

Esophageal reconstruction in infants is a much more delicate and difficult surgical procedure than in adults. The results on the other hand can be lifesaving or catastrophic. There may be several reasons for reconstructing the esophagus. One of them is the atresia or congenital absence of the esophagus. A case of total esophageal atresia is used for this lecture where the long term results are demonstrated. We advocate early esophageal reconstruction with left colon in infants one year old or less mainly because of multiple complications they go through if they have to wait years fighting high morbidity, until they are "accepted" for final surgical procedure. The quality of life for these infants and their parents is a lot better than with other surgical techniques. Also in our patients (few followed up for 20 years), no one has developed peptic colitis of the interposed colon. This of course is related to the surgical technique used for the cologastric anastomosis. The gastro-colonic anastomosis should be performed in a sphinteric fashion - Alvears' fashion is one style - in order to make sure no reflux of gastric contents occurs into the interposed segment of colon.