Abstract
The definition of long gap esophageal atresia in the past has always been controversial. In a recent position paper on long gap esophageal atresia, the definition was clearly determined as those types of atresia that had no air on plain abdominal X-rays, that is, type A and B.
Jejunal interposition is ideally suited for esophageal replacement if (delayed) primary anastomosis or traction technique is not possible or has failed. Although the technique needs meticulous dissection, in the follow-up, there remains good isoperistalsis, and the jejunum has a similar growth rate to that of the normal esophagus. There is little or no reflux and pulmonary symptoms are infrequent.
This chapter describes the surgical steps of jejunal interposition and follow-up. In comparison to other techniques, the jejunal interposition has a favorable outcome in the long run.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
van der Zee DC, Bagolan P, Faure C, Gottrand F, Jennings R, Laberge JM, Martinez Ferro MH, Parmentier B, Sfeir R, Teague W. Position Paper of INoEA Working Group on Long-gap esophageal atresia: for better care. Front Pediatr. 2017;5:63.
Akiyama H, Ishii K, Kodaira Y, et al. Esophageal reconstruction with a pedicled jejunum in esophageal atresia (type A). Shujutsu. 1971;25:711–9.
Bax KN. Jejunum for bridging long-gap esophageal atresia. Semin Pediatr Surg. 2009;18:34–9.
Bax KN, Roskott AM, van der Zee DC. Esophageal atresia without distal tracheoesophageal fistula: high incidence of proximal fistula. J Pediatr Surg. 2008;43:522–5.
Bax NM, van der Zee DC. Jejunal pedicle grafts for reconstruction of the esophagus in children. J Pediatr Surg. 2007;42:363–9.
Bairdain S, Foker JE, Smithers CJ, Hamilton TE, Labow BI, Baird CW, Taghinia AH, Feins N, Manfredi M, Jennings RW. Jejunal interposition after failed esophageal atresia repair. J Am Coll Surg. 2016;222(6):1001–8.
Gallo G, Zwaveling S, Van der Zee DC, Bax KN, de Langen ZJ, Hulscher JB. A two-center comparative study of gastric pull-up and jejunal interposition for long gap esophageal atresia. J Pediatr Surg. 2015;50(4):535–9.
van der Zee DC, Gallo G, Tytgat SH. Thoracoscopic traction technique in long gap esophageal atresia: entering a new era. Surg Endosc. 2015;29(11):3324–01.
Gallo G, Vrijlandt EJ, Arets HG, Koppelman GH, Van der Zee DC, Hulscher JB, Zwaveling S. Respiratory function after esophageal replacement in children. J Pediatr Surg. 2017:S0022-3468(17)30195-1.
Liu J, Yang Y, Zheng C, Dong R, Zheng S. Surgical outcomes of different approaches to esophageal replacement in long-gap esophageal atresia: a systematic review. Medicine (Baltimore). 2017;96(21).
Dingemann C, Eaton S, Aksnes G, Bagolan P, Cross KM, De Coppi P, Fruithof J, Gamba P, Goldschmidt I, Gottrand F, Pirr S, Rasmussen L, Sfeir R, Slater G, Suominen J, Svensson JF, Thorup JM, Tytgat SHAJ, van der Zee DC, Wessel L, Widenmann-Grolig A, Wijnen R, Zetterquist W, Ure BM. ERNICA consensus conference on the management of patients with long-gap esophageal atresia: perioperative, surgical, and long-term management. Eur J Pediatr Surg. 2021;31(3):214–25. https://doi.org/10.1055/s-0040-1713932. Epub 2020 Jul 15.PMID: 32668485.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Van Der Zee, D.C., Tytgat, S.S.H., Lindeboom, M.Y.A. (2021). Vascularized Jejunal Tube. In: Pimpalwar, A. (eds) Esophageal Preservation and Replacement in Children. Springer, Cham. https://doi.org/10.1007/978-3-030-77098-3_13
Download citation
DOI: https://doi.org/10.1007/978-3-030-77098-3_13
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-77097-6
Online ISBN: 978-3-030-77098-3
eBook Packages: MedicineMedicine (R0)