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Partial gastric pull-up in the treatment of patients with long-gap esophageal atresia

World Journal of Pediatrics 2015年第3期11卷 267-271页

作者： Marc Reismann Tina Granholm Henrik Ehrén Department of Pediatric Surgery and Urology Astrid Lindgren Children's HospitalKarolinska University HospitalStockholmSweden

Background:This study was to analyze outcomes of long-gap esophageal atresia(LGEA)treated with partial gastric pull-up(PGP)into the ***:The medical records of all children who had undergone PGP for LGEA from 1999 to 2012 were *** data,initial postoperative course,complications,time to full oral nutrition,follow-up diagnostics and nutritional status were ***:Nine children who had undergone PGP were followed up for a mean period of 6.2±3.1 *** median gestational age was 37+2 weeks,and mean birth weight 2462±658 *** children were primarily treated with a gastrostomy,their mean age at PGP was 11.4+10.9 weeks and mean weight was 4484+1966 *** mean operation time was 199+51 *** was an early postoperative complication in three children,one of whom had a consecutive stricture *** complications were stenosis(n=7)and gastro-esophageal reflux(n=5).The general status of the children was judged as"good"or"very good"on the last *** median percentile of the body-mass-index was *** at 3.7±3.2 years after the operation revealed a grade I esophagitis in two *** was no death in this group of ***:Because of its high complication rate,partial gastric pull-up cannot be recommended as an alternative for the treatment of LGEA at present.A final judgment could be made on the basis of a comparative study.

关键词： early childhood esophageal atresia gastric pull-up

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Graft dilatation and Barrett’s esophagus in adults after gastric pullup and jejunal interposition for long-gap esophageal atresia

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世界胃肠内镜杂志:英文版(电子版) 2023年第9期15卷 553-563页

作者： Eleonora Sofie van Tuyll van Serooskerken Gabriele Gallo Bas L Weusten Jessie Westerhof Lodewijk AA Brosens Sander Zwaveling Jetske Ruiterkamp Jan BF Hulscher Hubertus GM Arets Arnold JN Bittermann David C van der Zee Stefaan HAJ Tytgat Maud YA Lindeboom Department of Pediatric Surgery Wilhelmina Children’s HospitalUtrecht 3508 ABNetherlands Department of Pediatric Surgery University Medical Center GroningenGroningen 9713 GZNetherlands Department of Gastroenterology and Hepatology University Medical Center UtrechtUtrecht 3508 ABNetherlands Department of Gastroenterology and Hepatology University Medical Center GroningenGroningen 9713 GZNetherlands Department of Pathology University Medical Center UtrechtUtrecht 3508 ABNetherlands Department of Pediatric Surgery Amsterdam University Medical CenterAmsterdam 1105 AZNetherlands Department of Pediatric Pulmonology Wilhelmina Children’s HospitalUtrecht 3508 ABNetherlands Department of Pediatric Otorhinolaryngology Wilhelmina Children’s HospitalUtrecht 3508 ABNetherlands

BACKGROUND Esophageal replacement(ER)with gastric pull-up(GPU)or jejunal interposition(JI)used to be the standard treatment for long-gap esophageal atresia(LGEA).Changes of the ER grafts on a macro-and microscopic level however,are *** To evaluate long-term clinical symptoms and anatomical and mucosal changes in adolescents and adults after ER for *** A cohort study was conducted including all LGEA patients≥16 years who had undergone GPU or JI between 1985-2003 at two tertiary referral centers in the *** underwent clinical assessment,contrast study and endoscopy with *** was collected *** differences between JI and GPU patients,and associations between different outcome measures were assessed using the Fisher’s exact test for bivariate variables and the Mann-Whitney U-test for continuous *** with a P-valueup was 21.5 years and 24.4 years,*** was reported in six GPU patients(67%)vs four JI patients(36%)(P=0.37).Dysphagia symptoms were reported in 64%of JI patients,compared to 22%of GPU patients(P=0.09).Contrast studies showed dilatation of the jejunal graft in six patients(55%)and graft lengthening in four of these six *** revealed columnar-lined esophagus in three GPU patients(33%)and intestinal metaplasia was histologically confirmed in two patients(22%).No association was found between reflux symptoms and macroscopic anomalies or intestinal *** GPU patients(33%)experienced severe feeding problems vs none in the JI *** median body mass index of JI patients was 20.9 kg/m^(2) vs 19.5 kg/m^(2) in GPU patients(P=0.08).CONCLUSION The majority of GPU patients had reflux and intestinal metaplasia in 22%.The majority of JI patients had dysphagia and a dilated ***-up after ER for LGEA is essential.

关键词： Long-gap esophageal atresia Jejunal interposition gastric pull-up Barrett’s esophagus Intestinal metaplasia Esophageal replacement

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