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

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

doi: 10.1097/01.XPS.0000433919.71682.17
Original Articles

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.

Departments of aPediatric Surgery

bAnesthesia, King George’s Medical University, Lucknow, Uttar Pradesh, India

Correspondence to Anand Pandey, MS, MCh, Department of Pediatric Surgery, King George’s Medical University, Lucknow 226003, Uttar Pradesh, India Tel: +91 522 2257825; e-mail:

Received December 13, 2011

Accepted August 22, 2013

© 2014 Annals of Pediatric Surgery