Esophageal replacement in children: presentation of 18 cases and results of their surgical procedure

Background: Esophageal replacement is indicated in certain circumstances including long gap esophageal atresia, severe strictures due to gastro-esophageal reflux (GER) and caustic burns. We analyzed our results of 18 patients who underwent esophageal replacement in our university hospital. Methods: We reviewed esophageal replacements carried out in our department between June 1996 and August 2004. We report 18 patients (4 girls and 14 boys) with ages ranging from 3.5 until 30 months. Fifteen patients had long gap atresia, two had strictures due to GER, and one case had caustic burn. Esophageal replacement was performed through an abdominal midline incision by one of three methods, namely: colon transposition in 15, gastric replacement in 2, and gastric tube in 1 case. Results: Leakage and stricture were the most common complications of esophageal replacement. Most deaths were due to aspiration pneumonia and congenital cardiac disease. Conclusion: Esophageal replacement has limited indications. It allows a good functional result, with adequate oral feeding and normal growth.