Thoracic esophagostomy: a novel surgical approach for preservation of esophageal length for use in subsequent reconstruction.

摘要

The first patient was a newborn male patient with necrosis of the stomach, colon, and small bowel due to maternal abuse of crack cocaine. At 24 hours of age, the infant underwent total gastrectomy, right hemicolectomy, and subtotal small bowel resection. Due to intraoperative instability, reconstruction was delayed. An end esophageal thoracic esophagostomy was performed posteriorly through a resected portion of the 10th rib, just lateral to the paraspinal muscles (Figure 1, A). The infant was then allowed to grow and stabilize for 3 months with a feeding jejunostomy. At 3 months, the esophagostomy was taken down and the infant was reconstructed. The midtransverse colon was isolated as used with an end-to-side esophagocolostomy and a Roux-en-Y jejunocolostomy (Figure 1, B). Subsequently, he has done well and thrived.