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Annals of Pediatric Surgery:
doi: 10.1097/01.XPS.0000433919.71682.17
Original Articles

Esophageal replacement by gastric tube: is three-stage surgery justified?

Rawat, Jiledara; Pandey, Ananda; Singh, Sunitaa; Singh, Saritab; Kureel, Shiv N.a

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Abstract

Background

Long gap esophageal atresia with or without tracheoesophageal fistula is a challenging problem. We present our experience with the three-stage surgery technique.

Materials and methods

All patients with long gap esophageal atresia were operated by gastric tube esophagostomy in the second stage and esophagostomy closure in the third stage. The patients were then evaluated for intraoperative and postoperative complications, need for a ventilator, and follow-up.

Results

There were a total of eight patients. There were no intraoperative complications. There was no anastomotic leak in any patient. One patient died in the postoperative period because of respiratory distress. Follow-up of the remaining patients was satisfactory.

Conclusion

Three-stage surgery may avoid respiratory complications because of the short operative time and less intervention. Anastomotic leak and stenosis in the long esophageal suture line may also be avoided. This may be a useful alternative under a resource-limited condition, with optimal outcome.

© 2014 Annals of Pediatric Surgery

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