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Primary gastric pull-up in pure esophageal atresia: technique, feasibility and outcome. A prospective observational study

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Abstract

Aim

To perform a definitive procedure in pure esophageal atresia by gastric pull-up in the newborn.

Patients/methods

A primary gastric pull-up was performed in six newborns with pure esophageal atresia that presented between 1998 and 2009. The cervical esophagus was mobilized through the neck, the stomach was mobilized through laparotomy, the left gastric artery was ligated, and Pyloromyotomy was done. The stomach was brought into the neck via the trans hiatal route. A single-layer esophageo-gastric anastomosis was done in the neck in all.

Results

The mean birth weight was 2.1 kg (range 1.9–2.7) and the age at surgery varied from 3 to 7 days (mean 4.5 days). The mean operative time was 146 min. All six neonates received postoperative elective ventilation for a period of 2–7 days (mean 5.3). Epidural morphine was given for postoperative pain relief. Four received TPN for 5–13 days. Three had minor leaks from the neck wound that healed spontaneously. Mean hospital stay was 14.6 with a range 13–20 days. There was no mortality.

Conclusion

It is feasible to perform the gastric pull-up for long gap esophageal atresia in the newborn period, as a definitive procedure with no added risks to life in experienced hands.

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References

  1. Spicer RD, Cusick EL (1996) Esophageal substitution by jejunal free graft: follow up data and an evaluation. Pediatr Surg Int 11:227–229

    Article  Google Scholar 

  2. Vargas Gomez M (1994) Esophageal replacement in patients under 3 months of age. J Pediatr Surg 29:487–491

    Article  PubMed  CAS  Google Scholar 

  3. Hernandez F, Rivas S, Avila LF, Luis AL, Martinez L, Lassaletta L, Murcia FJ, Tovar JA (2003) Early esophageal replacement in patients with esophageal atresia. Cir Pediatr 16:112–115

    PubMed  CAS  Google Scholar 

  4. Spitz L (1996) Gastric transposition for esophageal replacement. Pediatr Surg Int 11:218–220

    Google Scholar 

  5. Spitz L, Kiely E, Pierro A (2004) Gastric transposition in children—a 21-year experience. J Pediatr Surg 39:276–281

    Article  PubMed  Google Scholar 

  6. Davenport M, Hosie GP, Tasker RC, Gordon I, Kiely EM, Spitz L (1996) Long-term effects of gastric transposition in children: a physiological study. J Pediatr Surg 31:588–593

    Article  PubMed  CAS  Google Scholar 

  7. Gupta DK, Bajpai M, Kataria R (1997) Esophageal replacement by stomach in children. Eur J Pediatr Surg 7:143–146

    Article  PubMed  CAS  Google Scholar 

  8. Gupta DK, Sharma S, Arora MK et al (2007) Esophageal replacement in the neonatal period in infants with esophageal atresia and tracheoesophageal fistula. J Pediatr Surg 42:1471–1477

    Article  PubMed  Google Scholar 

  9. Gupta DK, Srinivas M, Agarwala S et al (2003) Neonatal gastric pull up: reality or myth? Pediatr Surg Int 19:100–103

    PubMed  CAS  Google Scholar 

  10. Gupta DK, Charles AR, Srinivas M (2004) Manometric evaluation of the intrathoracic stomach after gastric transposition in children. Pediatr Surg Int 20:415–418

    PubMed  CAS  Google Scholar 

  11. Atwell JD, Harrison GS (1980) Observations on the role of esophagogastrostomy in infancy and childhood with particular reference to the long-term results and operative mortality. J Ped Surg 15:303–309

    Article  CAS  Google Scholar 

  12. Spitz L (2009) Gastric transposition in children. Semin Pediatr Surg 18:30–33

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, 110029, India

    Shilpa Sharma & Devendra K. Gupta

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  1. Shilpa Sharma
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  2. Devendra K. Gupta
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Correspondence to Devendra K. Gupta.

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Sharma, S., Gupta, D.K. Primary gastric pull-up in pure esophageal atresia: technique, feasibility and outcome. A prospective observational study. Pediatr Surg Int 27, 583–585 (2011). https://doi.org/10.1007/s00383-010-2835-7

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  • DOI: https://doi.org/10.1007/s00383-010-2835-7

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